SCHOOL    HYGIENE 


OR 


THE  LAWS  OF  HEALTH  IN  RELATION 
TO  SCHOOL  LIFE. 


BY 

ARTHUR    NEWSHOLME.    M.D., 

AND  DIPLOMATS   IN   PUBLIC   HEALTH,  UNIVERSITY   OF   LONDON;    UNIVERSITY   SCHOLAR   AND 

GOLD  MEDALLIST  IN  MEDICINE;    MEDICAL  OFFICER  OF  HEALTH  FOR  CLAPHAM ; 

MEDICAL  EXAMINER  OF  PUPIL  TEACHERS  TO  THE  SCHOOL  BOARD  FOR 

LONDON;   AND  MEDICAL  REFEREE  TO  THE  WESTMINSTER  AND 

SOUTHLANDS    TRAINING    COLLEGES    FOR    TEACHERS. 


BOSTON  : 

D.   C.   HEATH   &  CO.,   PUBLISHERS. 
1889. 


PREFACE. 

THE  importance  of  the  subject  here  discussed  must  be  evident 
to  all  who  have  bestowed  even  a  cursory  attention  on  the  sub- 
ject of  popular  education.  As  a  matter  of  fact,  it  has  engaged 
the  serious  attention  of  School  Boards  and  Committees,  and 
been  made  the  subject  of  repeated  legislation  by  the  Educa- 
tion Department.  The  result  of  all  this  is  seen  in  the  improved 
character  of  the  school-buildings  which  are  everywhere  being 
erected.  In  these,  we  find  that  greater  attention  is  paid,  not  only 
to  the  space  demanded  for  each  pupil,  to  which  a  few  years 
ago  the  official  legislation  was  almost  exclusively  confined,  but 
educationists  have  come  to  see  that  lighting,  warming,  ventila- 
tion, and  general  sanitary  conditions,  are  of  prime  importance 
in  their  bearing  on  the  health  and  progress  of  the  children 
gathered  in  these  schools. 

Much  still  remains  to  be  learnt  in  regard  to  these  matters,  and 
it  is  of  the  highest  importance  that  school-managers  and  all  who 
are  concerned  in  the  erection  of  school  premises— or  what  is 
perhaps  equally  important,  the  modification  of  already  existing 
schools— should  be  well  acquainted  with  the  principles  which 
determine  the  sanitary  condition  of  all  school  premises  and 
arrangements. 

But,  however  healthful  the  sanitary  conditions  of  school- 
premises,  it  is  evident  that  the  health  of  the  school  must  depend 


iV  Preface. 

also  largely  upon  the  routine,  the  distribution  of  work  in  relation 
to  age,  the  amount  of  exercise  and  rest,  and  other  matters 
which  concern  the  personal  treatment  of  the  scholars. 

This  branch  of  School  Hygiene  is  necessarily  more  exclu- 
sively in  the  hands  of  the  teacher,  and  it  is  therefore  important 
that  he  should  be  well  instructed  in  the  general  laws  of  health  as 
applied  to  school-life.  It  is  gratifying  to  observe  that,  after  re- 
peated references  to  the  subject  in  their  Official  Reports,  this 
has  been  finally  recognised  by  the  Education  Department  in 
their  last  Syllabus  for  Training  Colleges,  where  a  knowledge  of 
the  "  laws  of  health  as  applied  to  school  premises,  scholars, 
and  teachers,"  is  made  an  essential  part  of  the  professional 
training  of  teachers. 

The  present  manual  has  been  written  to  supply  accurate  in- 
ftfl-mation  on  these  two  branches  of  School  Hygiene,  and  it 
is  hoped  that  it  will  be  useful  to  all  interested  in  the  subject, 
and  especially  to  those  engaged  in  studying  it  in  Training 
Colleges  or  elsewhere. 

My  own  official  experience  as  Medical  Officer  of  Health, 
and  as  medical  referee  to  two  Training  Colleges,  as  well  as  to 
several  large  private  schools,  has  frequently  forced  the  study  of 
this  subject  upon  me,  and  given  the  opportunity  of  becoming 
acquainted  with  its  practical  details.  The  entire  subject  mav 
be  regarded  as  a  particular  application  of  the  general  Laws  o 
Health,  which  I  have  already  treated  in  detail  in  my  Manual  o 
Hygiene.  The  large  circulation  which  this  book  has  had,  and 
its  favourable  reception  by  teachers  and  scientific  authorities, 
encourage  me  to  hope  that  the  present  work  will  be  found 
equally  useful  and  acceptable. 

ARTHUR  NEWSHOLME. 
39,  HIGH  STREET, 
CLAPHAM,  S.We 


CONTENTS. 

PART  I.— SCHOOLS. 

PAGE 

CHAPTER  I.— SITE  OF  SCHOOL. 

Desiderata  of  Site.— Level  of  Ground-Water.— Consump- 
tion, Rheumatism.  &c.,  from  Damp  Soils. — Special  Sus- 
ceptibility of  Children  —Drainage  of  Soil.— Character  of 
Soil.— School  not  in  Main  Street.— Not  to  be  Over- 
shadowed. —Allow  for  Playgrounds.  ...  ...  ...  3 

CHAPTER  II.— CONSTRUCTION  OF  SCHOOL  BUILDINGS. 
Foundation  of  School.  —Walls.-  Style  of  Architecture.— Inter- 
nal    Wall-surfaces.— Floor.— Arrangement    of    Rooms.— 
Corridors.  -  Staircases. — Cloak-room. — Playground.          ... 

CHAPTER  III.— SCHOOL  FURNITURE.  7 

Desks  and  Seats.— Evil  Effects  of  Long-sitting  in  one  Pos- 
ture.—Varieties  of  Bad  Desks  and  Seats.— Results  of 
These.—"  Distance  "and  "  Difference."—  Slope  of  Desk.— 
Height  and  Width  of  Sea*.— Height  of  Back.— Long  or 
Short  Desk.— Desks  according  to  Height,  not  Age.— Black- 
board.— Pictures  ...  ...  ...  ...  12 

\    CHAPTER  IV.— LIGHTING  OF  SCHOOL-ROOMS. 
Evil  Effects  of  Deficient  Light.— Amount  of  Window-area 
required. — Direction  of  Light.— Artificial  Lighting  ...        17 

CHAPTER  V.— GENERAL  PRINCIPLES  OF  VENTILATION. 
Physiology  of  Respiration.— Tests    for    Impurity  of  Air. — 
Effects    of    Breathing    Impure    Air.— Effect    on    Mental 
Powers.— Temperature  of  Air  required. — Dryness  of  Air.— 
Amount  of  A,ir  required.— Amount  of  Floor  Space  ...        2fi 

CHAPTER  VI.— NATURAL  VENTILATION. 

Rules  Respecting  Ventilation.— Natural  and  Artificial  Ven- 
tilation.— Ventilation    through    Window,   Wall,  Chimney, 
Ceiling.  ...  ...  ...  ..  ...  ...        29 

CHAPTER  VI L— VENTILATION  AND  WARMING. 

Difficulties  of  Successful  Ventilation  by  Warm  Air.— Open 
Fire-place.— Heating  by  Gas.— Closed  Stoves.— Central 
S>stem  of  Heating.— Hot  Air  Furnaces.— Steam  Appara- 
tus.—Hot  Water  Apparatus.  -Entrance  Flues  and  Extrac- 
tion Shafts.— The  Bridgeport  System  ...  ...  ...  36 

CHAPTER  VIII.— DRAINAGE  ARRANGEMENTS. 
Lavatories,— Urinals. — Water-closets. — Soil-pipe.— Drains.— 
Earth-closets    ...  ...  ...  ...  ...  ...       46 


vi  Contents. 

PART  II.— SCHOLARS. 

PAGE 

CHAPTER  IX.— MENTAL  EXERCISE. 

Full  Scope  of  Education. — Quantity  and  Quality  of  Brain. — 
The  Brain  a  Compound  Organ. — Functional  Habits  of 
Brain  —  Blood  Supply. — Sensory  and  Muscular  Education 
of  Brain  .  ...  ...  ...  ...  ...  ...  57 

'    CHAPTER  X.— EXCESSIVE  MENTAL  EXERCISE. 

Symptoms  and  Effects  of  Brain-forcing.—!  he  "  Cram  "  Sys- 
tem.—Causes  of  Over-strain. — Home  Lessons.— Badly-ar- 
ranged \Vork. —  Importance  of  Technical  Instruction. — 
Good  and  Bad  Examinations. — Consumption  from  Over- 
work. -Punishments  ...  ...  ...  ...  ...  62 

CHAPTER  XL— AGE  AND  SF.X  IN  RELATION  TO  SCHOOL 
WORK. 

Duration  of  School-work  at  various  Ages.— Statistics  of 
Children  attending  School  at  various  Ages.  — Growth  and 
Development  in  Relation  to  School-work.— Weight  and 
Size  of  Children. — ehart  of  Growth  of  Children. — Sex  in 
Education. — Character  of  Education  in  Relation  to  Sex.  70 

CHAPTER  XI L— MUSCULAR  EXERCISE  AND  RECREATION. 
Analogy  between  Mental  and  Muscular  Exercise. — Influence 
of  Exercise  on  the  System.— Influence  on  the  Brain.— Ex- 
cessive Exercise. — Deficient    Exer<  ise. — Rules  for   Exer- 
cise.— Forms  of  Exercise.— Gymnastics.— Calisthenics     ...        83 

CHAPTER  XI II.— REST  AND  SLEEP. 

Law  of  Rest  and  Action.— Partial  Rest  —Complete  Rest. — 
Duration  of  Sleep.— Rules  respecting  Sleep. — School  Dor- 
mitories ...  ...  ...  ...  ...  ...  91 

CHAPTER  XIV.— CHILDREN'S  DIET. 

Quantity  and  Quality  of  Food. — Food  required  for  Growth. — 
Relation   of  Food  to  Work.— Frequency    of  Under-feed- 
ing.— Amount    of  Food    Required. —  School    Dietaries. — 
Water  at  School.  ...  ...  ...  ...  ...        95 

CHAPTER  XV. — CHILDREN'S  DRESS. 

Amount  of  Clothing  Required.— Relation  of  Clothing  to 
Food  — The  Hardening  Process. — Distribution  of  Cloth- 
ing.—Rules  respecting  Clothing  ...  ...  ...  99 

CHAPTER  XVI.— BATHS  AND  BATHING. 

Necessity  for  Cleanliness. — School  Baths  and  Swimming    ...       102 
CHAPTER  XVF I. —EYESIGHT  IN  RELATION  TO  SCHOOL  LIFE. 

Structure  of  the  Eye.— Causation  of  Long  and  Short  Sight. — 
Use  of  Eyes  for  Near  Objects.— Inadequate  Light.— Badly 
Printed  Books. — Fine  Needlework. — Influence  of  General 
Health  on  Eyesight.  ...  ...  ...  ...  ...  104 


Contents.  vii 

PAGE 

CHAPTER  XVIII. -COMMUNICABLE  DISEASES  IN  SCHOOLS. 
Moral  Duty  of  Parents  and  Medical  Men.— Symptoms  of  t  )n- 
set  of  Infectious  Diseases. — Rules  for  Guidance  of  Teach- 
ers.—Duration  of  Infection.— Isolation  of  Healthy  Members 
of  Household.  — Diseases  from  Insanitary  Schools.— Ques- 
tion of  Closing  Schools  for  Epidemics.— Management  of 
Infectious  Diseases  in  Boarding  Schools.— Other  Commu- 
nicable Diseases. —Ringworm. — Itch.  ..  ...  ...  116 

CHAPTER  XIX.— SCHOOL  ACCIDENTS. 
Importance  of  First  Aid.— Fainting.—  Fits.— Suffocation. — 
Drowning.  —  Foreign  Bodies.  —  Stings  and  Bites. — 
Wounds.— Haemorrhage.  — Nose  Bleeding  and  Spitting  of 
Blood.  —  Fractures.  —  Dislocations.  —  Sprains.—  Contu- 
sions.—Concussion.— Football.  ...  ...  ...  ...  131 

INDEX  —          ...          —          ~.          .«          ...     141 


LIST    OF    ILLUSTRATIONS. 


FIG.  PAGE 

1  Diagram  of  foundation  and  damp-proof  course  ...  8 

2  Diagram  of  desk  and  seat        ...           ...           ...  ...  1  5 

3  Ventilating  gas-pendant         ...           ...           ...  ...  20 

4  Ventilation  by  hinged  window            ...           ...  ...  31 

5  Ventilation  between  window-sashes     ...           ...  ...  32 

6  Ventilation  by  Tobin's  tube  and  exit-shaft  from  centre  33 

flower  of  ceiling  ... 

7  Sheringham's  ventilator          ...           ...           ...  ...  33 

8  Boyle's  mica  flap  ventilator   ...           ...           ...  ...  34 

9  Slow  combustion  ventilating-stove      ...           ...  ...  38 

10  The  Calorigen  stove...           ...           ...           ...  ...  39 

11  Closed  stove  arranged  to  warm  incoming  fresh  air  ...  41 

12  Lavatory  wash-basin...            ...            ...            ...  ...  47 

13  Pan-closet  with  D  trap  beneath           ...           ...  ...  48 

14  An  improved  valveless  closet              ...           ...  ...  49 

15  A  sanitary  v^alve-closet           ...            ...            ...  '...  50 

16  Section  of  disconnecting  chamber  for  school-drain  ...  51 

17  Iron  cover  to  disconnecting  chamber                ...  ...  52 

18  Chart  of  height  and  weight  from  birth  to  25  vcnrs  of  age  79 

19  Chair  giving  complete  spinal  support  ...  87 

20  Vertical  section  of  the  eyeball             ...  ...  105 

21  Diagram  showing  effect  of  biconvex  lens  on  light  106 

22  Section  of  hypermetropic  eye              ...           ...  ...  107 

23  Section  of  myopic  eye           ...           ...           ...  ...  109 

24  Chart  showing  prevalence  of    near-sight  and  far-  sight 

at  different  ages  ...                        ...           ...  ...  in 

25  The  Itch  Insect         ...           ...           ...           ...  ...  12; 

26  A  burrow  formed  by  the  Itch  Insect  in  epidermis  ...  126 

27  Ringworm    ...           ...           ...            ...            ...  ...  128 

28  The  inspiratory  movement  in  artificial  respiration  ...  133 

29  The  expiratory  movement  in  artificial  respiration  ...  134 


PART  I. 

SCHOOLS. 


OF  THB 

UHI7ERSIT7 


SCHOOC    HYGIENE. 


CHAPTER  I. 

SITE   OF    SCHOOL. 

Desiderata  of  Site. — Level  of  Ground-Water —Consumption^ 
Rheumatism,  &*c.t  from  damp  Soils.— Special  Susceptibility  of 
Children.— Drainage  of  Soil.— Character  of  Soil.— School  not  in 
Main  Street. — Not  to  be  Overshadowed. —  Allow  for  Play- 
grounds. 

FREQUENTLY  no  choice  can  be  exercised  as  to  the  site  of  a 
school.  The  school  already  exists,  and  must  be  adapted  as 
best  can  be  for  its  purposes.  Or,  again,  the  site  is  determined 
by  arbitrary  and  inevitable  circumstances,  such  as  the  question 
of  expense  of  ground,  central  position  for  the  children,  &c. 

In  all  cases  where  a  choice  is  possible,  the  following  require- 
ments should  be  carefully  fulfilled ;  and  where  an  unsuitable 
site  has  already  been  occupied,  it  should  be  brought  as  far  as 
possible  in  accord  with  the  conditions  to  be  named. 

(i.)  The  Level  of  the  Ground  or  Subsoil  Water  must  be 
carefully  ascertained.  Ever)'  soil  contains  water  at  a  certain  level 
below  its  surface,  the  depth  of  which  can  be  easily  ascertained  by 

3  B    2 


4  SCHOOL   HYGIENE. 

finding  the  height  of  the  water  in  the  nearest  shallow  well.  The 
basement-floor  should  be  at  least  three  feet  above  the  highest 
level  of  the  ground-water.  A  soil  in  which  the  ground-water  is 
usually  low,  but  liable  to  sudden  variations  in  level,  is  less  health- 
ful than  one  in  which  the  water  is  somewhat  near  the  surface, 
but  without  great  alternations.  The  close  relationship  of  Con- 
sumption to  excessive  moisture  of  soil  has  been  clearly  demon- 
strated in  England  by  Dr.  Buchanan,  and  in  America  by  Dr. 
Bowditch,  of  Boston. 

Rheumatism,  likewise,  is  favoured  by  damp  and  ill-drained 
sites. 

When  a  damp  soil  contains  decomposing  vegetable  matters, 
under  the  influence  of  the  warmth  of  late  summer  and  autumn 
months,  malarious  diseases  are  liable  to  be  produced. 

Ague,  the  type  of  malarious  diseases,  was  formerly  prevalent 
in  southern  New  England,  around  New  York  City,  and  many 
parts  of  New  Jersey.  Improved  drainage,  and  the  conse- 
quent increased  dryness  of  soil,  have,  however,  almost  en- 
tirely abolished  it.  Diphtheria,  again,  seems  to  be  connected 
in  its  origin  with  a  damp  soil,  though,  in  this  case,  a  defective 
condition  of  sewerage  is  generally  associated  with  the  damp- 
ness. 

In  connection  with  all  these  conditions,  children  are  much 
more  prone  to  suffer  than  adults.  Their  resisting  powers  are 
smaller,  and  they  sooner  fall  victims  to  the  results  of  bad 
hygienic  conditions. 

(2.)  Drainage  of  Soil.  —  No  matter  how  dry  may  be  the 
natural  condition  of  a  soil,  a  site  without  means  of  drainage 
should  not  be  accepted  at  any  price.  Even  a  clay  soil  may  be 
made  comparatively  warm  and  dry  by  means  of  brick  or 
perforated  earthenware  pipes.  These  should  preferably  not 
run  into  any  part  of  the  sewerage  system,  but  into  the  nearest 
water-course.  If  it  is  necessary  to  join  them  with  a  sewer, 


SITE   OF  SCHOOL.  5 

their  contents  should  not   pass  directly  into  it,   but  into  a 
disconnecting  trap. 

(3.)     Character  of  the  Soil. — "  M  ide  "  soils,  often  consisting 
of  the  refuse  and  garbage  collected  from  dust  bins,  should  be 
carefully  avoided.     The  gradual  putrefaction  of  such  organic 
matters,    leads    to  the  production  of  effluvia,  which   mount^, 
into  the    school-rooms,  and  may    develope    diphtheria    and" 
other  diseases.  Sandy,  or  coarse  gravel  soils  are  to  be  preferred. 
Clay  soils  are   cold  and  retentive  of  moisture,   unless   very 
well   drained. 

(4.)  .Relation  of  Site  to  surroumiing  Objects.—  The  neighbour- 
hood of  stagnant  pools  or  marshy  ground  is  to  be  studiously 
avoided,  as  it  is  open  to  the  dangers  which  are  necessarily 
associated  with  the  slow  putreJa<ni'.jri  of  organic  matters.  The 
vicinity  of  any  factory,  or  other  establishment  liable  to 
poison  the  air  with  offensive  effluvia,  should  likewise  be 
avoided. 

India-rubber  WOIKS,  tar.-ya?ds,  bone-boiling  and  seap- 
making  establishments  are  particularly  objectionable.  The 
neighbourhood  of  gas-works  is  objectionable  in  a  minor 
degree.  If  the  neighbourhood  of  a  factory  or  workshop  is 
associated  with  the  noise  of  machinery,  serious  interference 
with  school-work  may  result. 

Position  in  a  main  street  is  by  no  means  always  advisable. 
Apart  from  the  noise  which  interferes  with  attention  to  school- 
work,  there  is  more  danger  of  children  being  run  over  while 
hurrying  from  school,  than  if  the  exit  is  in  a  side  street.  Prox- 
imity to  foundries,  railway  stations,  markets,  or  stables  is  un- 
desirable. The  close  neighbourhood  of  trees,  except  to  north 
or  east,  is  to  be  deprecated,  and  then  they  should  not  be  suf- 
ficiently near  to  impede  the  free  entrance  of  light  or  air.  The 
close  vicinity  of  higher  buildings  is  for  similar  reasons  objec- 
tionable. 


6  SCHOOL    HYGIENE. 

The  site  should  be  sufficiently  extensive  to  allow  for  play- 
grounds. This  is  not  only  necessary  for  recreation,  but  it  pre- 
vents to  some  extent  the  overshadowing  of  surrounding  build- 
ings. At  least  two  adjoining  sides  of  the  school  should 
be  freely  exposed  to  light  and  air,  and  at  a  distance  of 
not  less  than  60  feet  from  any  other  building. 


CHAPTER  II. 
CONSTRUCTION  OF  THE  SCHOOL  BUILDINGS. 

Foundation  of  School  —  Walls.— Stvle  of  Architecture.— Internal 
Wall-surfaces. — Floor.—  Arrangement  of  Rooms.  —Corridors. — 
Staircases. — Cloak-room. — Playground. 

IT  is  most  convenient  to  discuss  first  the  general  construction 
and  arrangement  of  school  buildings,  leaving  the  subjects  of 
lighting,  ventilation,  warming,  and  drainage  to  later  chapters. 

The  School  Foundation  requires  to  be  solid  and  substantial 
and  made  as  nearly  as  possible  impervious  both  to  moisture 
and  air,  in  order  to  cut  off  the  ground-air,  which  is  otherwise 
drawn  into  heated  rooms,  and  may  contain  the  germs  of  diph- 
theria, enteric  fever,  or  some  other  disease.  Impervious 
concrete,  hydraulic  cement,  asphalted  brick,  or  sheet-lead  are 
among  the  best  materials  for  this  purpose.  The  impervious 
material  should  reach  on  each  side  at  least  six  inches  beyond 
the  frontage  of  the  wall.  (Fig.  i.) 

The  Wjlls  should  likewise  have  special  arrangements  for 
preventing  the  rise  of  damp.  Two  layt  rs  of  roofing  slate  set 
in  cement,  or  a  layer  of  good  asphalte,  or  a  course  of  perforated 
glazed  tiles,  form  a  good  damp-proof  course.  When  we  re- 
member that  a  common  brick  will  absorb  a  pint  of  water,  and 
that  moisture  rises  along  the  bricks  of  a  building,  just  as  it 
7 


8 


SCHOOL   HYGIENE. 


would  run  up  a  series  of  lumps  of  sugar  arranged  on  the  top  of 
eacn  other,  the  importance  of  this  matter  will  be  realised. 


FIG.  i. — Diagram  showing  Foundation  and  Damp-proof  Course. 
a.  Concrete  Foundation.     I.  Damp-proof  Course 

The  Style  of  Architecture  may  be  regulated  according  to  local 
circumstances,  but  should  be  such  as  not  to  be  an  offence  to 
the  eye,  or  out  of  harmony  with  its  environment.  Expensive 
ornamentation  should  never  be  indulged  at  the  expense  of 
efficient  ventilating  or  warming  apparatus. 

The  Internal  Will-surfaces  should  not  be  papered,  as  they 
cannot  then  be  frequently  cleansed.  '""If  simply  white- washed 
or  colour-washed,  the  plaster  of  the  room  for  a  time  serves  to 
neutralise  the  carbonic  acid  from  respiration,  but  afterwards 
this  action  ceases,  and  the  walls  become  saturated  with  volatile 
organic  matters  from  respiration,  &c.,  which  tend  to  maintain 
the  atmosphere  in  an  impure  condition,  even  though  fresh  air 


CONSTRUCTION   OF   THE   SCHOOL    BUILDINGS.  9 

is  admitted  Washable  distempers  are  very  good,  and  they 
present  the  advantage  that  their  colouring  matter  does  not  rub 
off  on  the  clothes. 

It  is  preferable  to  have  impervious  polished  walls,  made  thus 
by  painting,  or  by  polished  cement,  or  tiles.  These  can  be 
frequently  washed,  and  thus  the  atmosphere  kept  sweet  and 
pure  If  the  walls  are  coloured,  the  tints  should  be  cream  or 
light  brown,  or  a  pale  blue  or  green. 

The  wainscoting  should  be  four  to  five  feet  high.  All  pro- 
jections which  can  harbour  dust  should  be  as  far  as  possible 
abolished.  Thus  cornices  are  objectionable,  and  the  tops  of 
doors  and  windows  should  be  levelled  off. 

The  Moor  of  the  school-room  should  be  constructed  of 
narrow  planks,  with  dovetailed  or  matched  joints.  The  wood 
should  be  close-grained  and  hard,  so  as  not  easily  to  splinter. 
Wood  floors  are  warmer  than  asphalte  or  brick.  The  floor 
may  be  washed  duiing  the  school  recess,  but  must  be  well 
dried.  A  better  plan  is  to  have  it  beeswaxed  and  polished  at 
intervals  :  it  then  only  requires  sweeping  each  day. 

The  F/uot  Plan  should  be  carefully  devised.  A  form  of 
building  in  which  a  central  corridor  is  surrounded  by  class- 
rooms on  three  or  four  sides  is  not  advisable,  as  it  does  not 
allow  a  free  circulation  of  air.  A  better  arrangement  is  to  have 
rooms  on  only  one  side  of  a  corridor,  so  that  the  chief  light  comes 
from  one  side  of  the  rooms.  The  best  sh.ipe  for  school-rooms 
is  an  oblong,  the  sides  of  which  bear  the  proportion  of  about 
4  to  3,  each  room  allowing  150  cubic  feet  per  pupil,  of  which 
at  least  15  square  feet  should  be  floor-space.  The  minimum 
Government  requirement  in  England  is  80  cubic  feet  per 
pupil,  not  less  than  8  square  feet  of  which  must  be  allowed  for 
floor-space.  In  common  lodging-houses,  if  the  cubic  space 
allowed  per  individual  is  below  300  cubic  feet,  the  proprietor 
is  liable  to  prosecution.  We  axe  therefor^aLArerstating  the 


OP 

('UNIVERSITY] 
*       ~*.<AV^ 


10  SCHOOL   HYGIENE. 

matter  in  saying  that  150  cubic  feet  per  pupil  is  desirable  in  a 
school. 

Corridors  should  be  large,  airy,  and  well  lit.  If  they  are 
cramped  for  space,  or  have  not  an  abundance  of  direct  light 
the  ventilation  of  the  school  is  sure  to  suffer. 

Staircases  should  be  fire  proof,  and  so  situated  that,  in  case 
of  fire,  there  is  easy  access  to  them.  There  should  be  two 
separate  flights  of  stairs,  neither  of  which  should  be  directly 
opposite  a  door.  A  landing  should  break  the  stairway  abou«- 
every  15  steps,  in  order  to  avoid  falls  from  a  great  height. 
The  door  should  open  outward  toward  the  street,  to  prevent  £ 
block  in  case  of  panic,  and  the  doorway  should  always  bf 
wider  than  the  stair  which  leads  to  it.  Spiral  stairs 
without,  landings  and  having  tapered  steps  are  most  objec 
tionableA 

Cloak-rooms  should  be  provided  in  every  public  school,  the 
children's  outer  clothing  and  umbrellas  never  being  allowed  in 
the  school-room.  Each  child  should  have  a  separate  numbered 
place  for  hanging  his  outdoor  costume.  By  this  means  the 
danger  of  wetting  one  another's  clothes  and  of  infection  is 
minimised. 

There  should  be  a  system  of  umbrella-drainage,  channels 
communicating  with  all  the  compartments,  to  carry  the  drip- 
pings straight  out  of  the  school.  A  system  of  hot-water  or 
hot-air  pipes  should  run  under  all  the  compartments,  so  as 
to  subject  each  coat,  hat,  and  umbrella  to  a  current  of  hot  air 
and  dry  them.  To  facilitate  rapid  and  orderly  assembly  and 
dismissal,  it  is  desirable  that  there  should  be  a  separate  cloak- 
room for  each  120  to  150  scholars,  contiguous  to  the  respective 
class-rooms.  It  should  be  well  ventilated  to  carry  off  the 
vapour  produced  by  wet  clothing. 

The  Playground  should  be  as  large  as  circumstances  will 
allow.  If  possible,  it  should  not  be  on  the  north  or  east  side 


CONSTRUCTION    OF   THE   SCHOOL    BUILDINGS.  II 

of  the  school,  the  south  or  west  being  preferred.  A  por- 
tion of  it  should  be  covered,  especially  in  the  case  of  infant- 
schools.  This  may  i  e  obtained  by  having  a  light  shed,  open 
at  one  side,  or,  if  ground  is  expensive,  by  raising  the  school 
on  a  low  story,  eight  to  nine  feet  high,  and  using  the  ground 
underneath  as  a  covered  playground.  Some  of  the  recently 
built  public  schoolhouses  in  England  have  flat  roofs  for  play- 
ground purposes.  If  due  precautions  are  taken  to  prevent 
the  possibility  of  accidents,  this  plan  may  be  very  serviceable 
where  economy  of  space  is  essential. 


CHAPTER  III. 
SCHOOL    FURNITURE. 

Desks  and  Seats. — 'Evil  results  of  long-sitting  in  one  posture.— 
Varieties  of  bad  Desks  and  Seats.— Effects  of  these.— "Distance* 
and    "  Difference." -Slope     of   Desk. -Height   and    Width    of 
Seat.— Height  of  Back.— Long  or  Short  Desk.— Desks  accord- 
ing  to  Height,  not  Age. — Blackboard.— Pictures. 

DESKS  AND  SEATS  are  the  most  important  articles  of  school 
furniture,  and  it  is  unfortunate  that  authorities  on  this  subject 
are  not  agreed  as  to  their  best  form. 

It  is  well  to  remember  at  the  outset  that  no  form  of  desk  or 
scat  wi  1  obviate  the  evils  of  long  continuance  in  any  one 
position.  This  leads  to  imperfect  expansion  of  the  lungs, 
relaxation  of  muscles,  and  a  tendency  to  drooping  shoulders, 
if  not  actually  to  a  twist  in  the  spinal  column.  A  few  moments' 
interval  during  a  writing  lesson,  devoted  to  arm  exercises,  will 
be  extremely  beneficial  in  maintaining  proper  postures. 

Various  bad  forms  of  DESK  are  met  with.  The  desk  may  be 
too  high)  in  which  case,  during  writing,  one  shoulder  is  unduly 
raised  in  order  to  rest  the  arm  on  the  desk,  and  a  lateral  twist  of 
the  spine  results,  which,  in  time,  tends  to  become  persistent. 
If  the  desk  is  too  !<w>,  the  scholar  has  to  bend  too  far  over  his 
work.  A  forward  stoop  and  round  shoulders  are  produced  ; 
the  head  becomes  congested  from  being  held  so  low,  and  there 
is  a  strong  tendency  for  the  development  of  near-sightedness. 
(See  Chapter  XVII.) 

12 


SCM  JOL   FURNITURE.  13 

A  flat  desk  is  particularly  bad,  necessitating  a  cramped 
position,  and  interference  with  free  respiration. 

If  the  desk  is  too  far  from  the  seat,  a  forward  stoop,  with 
round  shoulders,  flat  chest,  and  injury  to  the  eyes,  is  produced. 

SEATS,  again,  may  be  badly  placed.  If  the  seat  is  too  high,  the 
feet  swing,  the  vessels  and  nerves  at  the  back  of  the  legs  are 
compressed,  and  the  sensation  of  "  pins  and  needles  "  is  pro- 
duced. This  is  also  very  apt  to  occur  if,  as  is  commonly  the 
case,  the  seat  is  too  narrow  to  support  the  whole  length  of  the 
thigh.  If  too  Iw,  the  thighs  are  bent  up  towards  the  body, 
and  a  cramped  position  is  produced.  If  without  a  back-rest, 
or  with  an  improperly  adapted  back-rest,  the  pupil  tends  to  lean 
forward  on  the  desk,  and  thus  prevent  free  expansion  of  the 
lungs. 

HI  Effects  of  bad  Desks  and  Seats. — According  to  Eulenberg, 
a  distinguished  German  orthopaedic  surgeon,  90  per  cent,  of 
curvatures  of  spine  not  caused  by  actual  bone-disease,  are 
developed  during  school  life  Bad  postures  during  school 
work,  and  especially  the  twisted  position,  with  the  left  arm  resting 
on  the  desk  during  writing  lessons,  contribute  considerably 
to  the  production  of  such  curvatures.  The  effects  are  much 
more  likely  to  be  produced  if  desk  and  seat  are  not  properly 
adapted  to  each  other,  and  to  the  size  of  the  pupil.  An  upright 
position  in  writingjs  indispensable,  and  the  left  elbow  should 
not  be  allowed  to  rest  high  up  on  the  desk.  Writing  should 
l)i  continued  for  only  a  few  minutes  in  infant  and  junior  classes, 
and  in  higher  classes  not  longer  than  half-an-hour,  without 
intermission. 

The  cramped  positions  induced  by  defective  desks  and 
seats,  not  only  favour  the  production  of  a  twisted  spine,  but 
also  round  shoulders  and  flat  chest,  t!  us  impeding  the 
functions  of  heart  and  lungs.  The  habit  of  leaning  forward 
close  over  the  copy-book  or  reading-book,  may  produce  short- 


14  SCHOOL   HYGIENE. 

sightedness ;  and  this  in  its  turn  increases  the  necessity  for  the 
improper  postures.  Thus  a  vicious  circle  is  entered,  each 
evil  mutually  intensifying  the  other. 

Prop,  r  Desks  and  Seats  should  be  accurately  adapted  to 
each  other.  The  most  important  points  to  ascertain  are  the 
"Distance,"  i.e.,  the  distance  between  the  edge  of  the  seat 
and  a  perpendicular  line  dropped  from  the  edge  of  the  desk ; 
the  "  Difference,"  i.e.,  the  difference  between  the7  height  of  seat 
and  desk  ;  and  the  slope  of  the  desk.  ,(Fig.  2.) 

The  Distance  should,  for  writing  purposes,  equal  zero, — the 
plumb  line  from  the  desk  grazing  the  edge  of,  the  seat, — or  it 
shoulc.  be  i  negative  quantity.  For  other  purposes  the  distance 
should  equal  zero  or  a  small  positive  quantity.  This  involves 
having  a  moveable  seat,  unless  chairs  are  used,  which  is  in- 
advisable in  boys'  schools.  Or,  the  same  end  may  be  attained 
by  using  a  desk  so  constructed  that  it  can  be  drawn  horizontally 
backward,  so  as  to  enable  the  scholar  to  write  while  sitting 
erect,  or  resting  his  back  against  the  back  of  the  seat^_  When 
the  scholar  is  too  far  away  from  the  desk,  he  either  bends  for- 
ward into  an  unnatural  position,  or  glides  too  far  forward  on  his 
seat,  and  occupies  an  unsteady  position. 

The  Difference  between  height  of  seat  and  desk  should  not 
be  such  that  the  shoulders  are  painfully  screwed  up  in  writing, 
or,  on  the  other  hand,  the  pupil  is  obliged  to  lean  forward  in 
order  to  write  or  read.  It  is  recommended  that  it  should  equal 
the  length  of  the  foR-arm,  or  about  one-sixth  the  height 
of  the  scholar  (Robson),  in  which  case  it  will  be  found  that 
the  under-part  of  the  forearm  will  rest  comfortably  on  the 
desk-top. 

The  Slope  of  the  Desk  should  be  capable  of  change,  the 
proper  angle  being  about  30°  for  writing  and  40-45°  f°r 
reading. 

The  Height  oj  the  Scat  should  correspond  to  the  length  of 


SCHOOL   FURNITURE. 


the  scholar's  leg  from  sole  of  foot  to  knee,  in  order  that  there 
may  be  no  stretching  of  muscles.  Its  width  should  not  be 
under  eight  inches. 

There  should  be  a  back  to  the  seat,  which  need  not  be  more 
than  a  piece  of  wood  3  inches  broad,  slightly  tilted  back,  and 
so  placed  as  to  support  the  back  just  below  the  shoulder 
blades.  In  this  way  the  movements  are  not  interfered  with, 
while  the  spine  receives  steady  support.  Liebreich  gives  the 
rule  that  the  top  of  the  back  of  the  seat  should  be  an  inch 
lower  than  the  edge  of  the  desk  for  boys,  and  an  inch  higher 
than  the  same  point  for  girls. 


tFic.  a.- -Diagram  of  Desk  and  Seat. 
be,  angle  of  30°  for  writing. a1  b  c,  an^le  of  45°  for  read'ng  ;    b  </=}  height 
of  scholar;    */=at  least   8  inches;  e  ^=length  of  schohr's  leg  from  knee 
to  sole  of  foot  ;  d  ^=not  more  than  I  inch  for  reiding,  and  zero  for  writing, 
and  preferably  zero  for  both,     b  d="  Difference."  de="  Distance." 

Long  desks  are,  as  a  rule,  objectionable  :  children  tend  to 
sit  with  the  left  arm  high  up  on  the  desk,  in  order  to  prevent 
copying  by  their  neighbours,  and  thus  produce  twisting  of 
their  spines.  The  same  objection  holds  against  dual  desks  to 


1 6  SCHOOL   HYGIENE. 

a  less  extent,  but  they  possess  the  advantage  of  not  spreading 
out  the  children  so  much  as  single  desks,  and  thus  economise 
the  teacher's  voice.  They  also  suffice  for  three,  when  listening 
to  a  lesson. 

It  is  a  common  fault  to  furnish  a  room  with  desks  of  only 
one  size.  There  should  be  three  sizes  of  desks  in  each  large 
class  room,  as  there  may  be  great  diversity  of  height  among 
children  differing  only  two  or  three  years  in  age.  A  foot -rest 
should  always  be  provided  for  children  varying  considerably 
from  the  usual  stature. 

Other  articles  of  school  furniture  require  little  notice. 

The  Black  Board  should  be  large.  It  should  be  so  placed 
as  to  receive  a  good  light,  and  its  surface  should  be  dull.  The 
windows  of  the  school-room  should  not  be  on  the  same  wall  as 
the  black  board,  as  otherwise  the  children's  eyes  are  dazzled 
in  looking  at  the  board. 

Pictures  in  schools  have  a  great  educational  value.  None 
are  so  easily  affe.  ted  and  impressed  by  their  surroundings 
as  children.  Hence  the  importance  of  surrounding  them  with 
beauties  of  form  and  colour,  thus  fostering  their  taste,  while 
the  daily  discipline  of  school  life  promotes  habits  of  order.  A 
common  fault  to  be  avoided  is  having  the  pictures  too  small 


CHAPTER  IV. 

.LIGHTING  OF  SCHOOL-ROOMS. 

Evil  Effects    of   Deficient    Light.— Amount     of     Window- are* 
required.— Direction  of  Light.— Artificial  Lighting. 

THE  depressing  effects  of  a  dull  day,  which  largely  depend 
Dn  the  absence  of  direct  sunlight,  are  sufficiently  known  to  all. 
Light  and  happiness  seem  necessarily  associated,  and  are  even 
used  as  synonymous  in  the  well-known  verse — "  Light  is  sown 
for  the  righteous,  and  gladness  fop  the  upright  in  heart." 

The  best  way  to  stop  a  canary  singing  is  to  cover  his  cage 
with  a  shade ;  and  the  bright  spirits  of  children  are  similarly 
affected  by  dull  dark  school-rooms.  The  mental  effect  of 
deficient  light  is  accompanied  by  an  actual  physical  effect 
Plants  grown  in  the  dark  are  weakly  and  white ;  and  human 
beings  under  similar  conditions  become  pale  and  comparatively 
bloodless  (anaemic).  "Where  the  light  cannot  come,  the 
doctor  must,"  is  a  proverb  expressing  this  truth  in  a  pithy 
form.  The  attendance  in  a  badly-lit  school  is  always  less 
regular  than  in  a  cheerful  well-lit  school. 

Small  windows,  often  half  shaded  by  blinds,  and  seldom  as 
clean  as  they  might  be,  are  common  defects  in  our  schools. 
The  furniture  and  paints,  again,  are  not  uncommonly  daik- 
coloured,  which  increases  the  general  gloom.  Varnishing 
the  walls  greatly  improves  the  lighting.  Not  only  is  a  badly- 
17  c 


ig  SCHOOL   HYGIENE. 

lit  room  injurious  in  itself,  but  it  leads  to  an  increased  use  of 
lamps  or  gas,  thus  bringing  into  action  another  source  of 
impurity. 

The  Window  Area  required  in  a  school-room  is  variously 
stated  as  from  one-fourth  to  one-tenth  of  the  floor-area  of  the 
room.  The  plan  recommended  by  R.  Morris  is  to  multiply 
the  length,  breadth,  and  height  of  the  room  together,  and  take 
the  square  root  of  this  for  the  area  of  the  windows. 

It  is  evident  that  the  amount  of  window-area  required  will 
vary  with  external  conditions.  Thus,  in  towns  more  should  be 
allowed  than  in  the  country,  and  more  in  a  narrow  street  than 
where  there  is  an  uninterrupted  outlook.  Also,  more  is 
required  in  the  lower  than  the  higher  stories.  A  greater 
amount  of  light  is  obtainable  from  skylights  than  from  vertical 
windows. 

Windows  should  always  reach  nearly  to  the  ceiling,  as 
the  best  light  comes  from  the  highest  point,  and  much 
of  the  cheerfulness  of  a  scrfool-room  depends  on  the  amount 
of  sky  which  is  visible.  Plate  glass  is  preferable,  being 
thicker,  and  allowing  less  escape  of  heat.  Double  windows 
check  cold  draughts  and  economise  heat.  They  may  also 
be  made  to  materially  help  natural  ventilation,  by  allowing 
an  upward  current  between  them  into  the  room.  Ground 
glass  windows  prevent  glare.  If  the  access  of  light  is  barred 
by  an  opposite  wall,  this  may  be  painted  or  white-washed, 
and  the  use  of  " Daylight  Reflectors"  is  sometimes  very 
advantageous. 

South  windows  admit  more  light  than  any  other ;  but  if  any 
part  of  the  lighting  is  from  the  roofs,  do  not  let  the  skylight 
slope  to  the  south  or  west,  as  the  heat  and  light  will  be  intoler- 
able in  hot  weather. 

The  Direction  of  the  Light  is  a  matter  of  great  importance. 


LIGHTING   OF   SCHOOL-ROOMS.  19 

The  worst  light  is  that  which  comes  from  windows  facing 
the  scholars.  It  throws  the  teacher's  face  into  the  shade, 
and  the  scholars'  books  are  similarly  affected.  A  light 
from  behind  obliges  the  scholar  to  sit  in  a  twisted  position,  in 
order  that  his  book  may  not  be  in  the  shade.  Light  from 
both  right  and  left  throws  a  double  set  of  shadows,  unless  the 
amount  of  illumination  from  one  side  (which  ought  to  be 
the  left)  is  much  greater  than  from  the  opposite  side.  If 
this  condition  is  fulfilled,  there  is  no  serious  objection  to 
cross-lighting,  and  it  greatly  facilitates  ventilation.  The 
best  light  is  that  which  comes  directly  from  the  left,  and 
does  not  necessitate  any  other  than  an  erect  posture  in  order 
that  it  may  fall  directly  on  the  desk.  The  lower  panes  of 
windows  are  of  comparatively  little  use  in  admitting  light  for 
study ;  the  light  comes  too  horizontally,  and  there  is  more 
danger  of  dazzling  the  eyes. 

A  semicircular  arrangement  of  the  seats  in  a  room,  is  dis- 
advantageous for  lighting  purposes.  There  should  be  a  gang- 
way pear  the  left-hand  windows,  to  prevent  the  children  nearest 
them  being  in  the  shade. 

Excess  of  Light  is  much  more  easily  remedied  than  a  defi- 
ciency. Inside  rolling  slat-blinds  answer  the  purpose,  but 
external  Venetian  or  other  blinds  are  much  more  effectual  in 
keeping  out  the  heat  of  the  sun. 

Artificial  Lighting  is  only  exceptionally  required  in  day- 
schools  ;  and  the  corridors  should  be  so  constructed  as  not  to 
require  its  aid. 

The  electric  light  possesses  great  sanitary  advantages  in  its 
freedom  from  injurious  products  of  combustion,  and  in  the 
fact  that  it  does  not  harm  books  and  paintings. 

Gas  is  the  usual  source  of  artificial  light.  As  ordinarily 
employed,  it  is  pernicious,  because  it  dries  the  air,  produces 
heat  out  of  all  proportion  to  the  light,  and  loads  the  air  with 

C   2 


20 


SCHOOL   HYGIENE. 


noxious  gases.  It  should  never  be  allowed  in  a  school-room, 
unless  contained  in  a  cylinder  which  carries  off  the  products  of 
combustion,  either  directly  to  the  external  air  (Fig.  3),  or  into 
the  chimney-flue.  It  may  in  this  way  be  so  arranged  as  to 
form  a  valuable  aid  to  ventilation. 


FIG.     3.— Ventilating  Gas  Pendant, 


CHAPTER  V. 
GENERAL  PRINCIPLES  OF  VENTILATION. 

Physiology  of  Respiration.— Tests  for  Impurity  of  Air.— Effects 
of  Breathing  Impure  Air.— Effects  on  Mental  Powers.— Tem- 
perature of  Air  Required,— Dry  ness  of  Air.—Amouut  of  Air 
Required* — Amount  of  Floor  Space. 

IT  has  been  well  said  that  "  our  own  breath  is  our  greatest 
enemy,"  and  the  problem  of  a  healthful  school-room  is  to  a 
large  extent  solved  by  the  application  of  measures  for  removing 
this,  and  furnishing  an  abundant  supply  of  pure  air,  without 
the  production  of  perceptible  draughts. 

A  knowledge  of  the  Physiology  of  Respiration  is  necessary 
before  the  importance  of  ventilation  can  be  realised,  and  the 
amount  of  fresh  air  required  can  be  ascertained.  The  essential 
element  in  the  atmosphere  is  oxygen,  a  gas  which  is  diluted 
by  four  times  its  volume  of  nitrogen,  an  innocent  gas  without 
any  active  properties.  The  oxygen  of  air  is  absolutely 
essential  for  the  continuance  of  all  forms  of  animal  life.  By 
means  of  our  lungs,  it  is  furnished  to  the  system,  and  at  the 
same  time  carbonic  acid  gas  and  other  impurities  are  eliminated. 

The  windpipe  carrying  air  down  to  the  lungs  branches 
repeatedly,  the  ultimate  minute  branches  ending  in  little 
cavities,  called  air-cells,  of  which  there  are  probably  five  or  six 
millions,  with  an  aggregate  area  of  ten  to  twenty  square  feet. 
This  large  area  is  separated  only  by  extremely  delicate  walls 

21 


22  SCHOOL   HYGIENE 

(so  delicate  as  to  be  hardly  recognisable)  from  the  blood 
circulating  in  the  lungs  ;  and  an  interchange  is  rapidly 
effected,  by  which  the  blood  becomes  oxygenated  and  at  the 
same  time  parts  with  its  impurities.  Now  the  heart  is  con- 
tracting from  60  to  70  times  every  minute,  at  each  contraction 
driving  the  blood  to  every  part  of  the  body,  including  the 
lungs  ;  and  it  is  found  that  the  whole  blood  passes  through  the 
lungs,  and  is  subjected  to  this  purifying  influence  nearly  twice 
every  minute. 

The  air  expired  differs  from  that  inspired  in  sevenal  impor- 
tant particulars.  In  the  first  place,  it  has  become  warmer, 
having  been  warmed  by  its  contact  with  the  warm  blood  which 
is  flowing  through  the  lungs.  In  the  next  place,  it  is  moister,  a 
large  amount  of  water-vapour  being  given  off.  By  the  lungs 
and  skin  conjointly,  from  26  to  40  ounces  of  water  pass  off  in 
24  hours.  Five  hundred  children  assembled  in  one  room 
would,  in  the  course  of  two  hours,  give  off  as  vapour  about 
four  gallons  of  water,,  which  would  be  visible  in  the  clouding  of 
windows  and  walls,  unless  the  room  were  well  ventilated. 

In  the  third  place,  expired  air  contains  four  per  cent,  less 
oxygen  and  over  four  per  cent,  more  carbonic  acid  than 
that  inspired.  Ordinary  out-door  air  contains  four  parts  of 
carbonic  acid  in  10,000  of  air,  but  in  expired  air  this  is  in- 
creased to  400  parts.  Healthy  adults  exhale  about  14-4  cubic 
feet  of  carbonic  acid  per  day.  Children  are  said  to  produce 
less  than  this,  but  as  their  vital  processes  are  more  rapid  than 
those  of  adults,  the  difference  is  not  so  great  as  might  be 
expected.  Five  hundred  children  assembled  in  one  room 
would  in  two  hours  produce  as  much  carbonic  acid  as  is 
equivalent  to  the  solid  charcoal  or  carbon  contained  in  2olbs 
of  coal. 

In  the  last  place,  expired  air  contains  in  suspension  con- 
siderable volatile  organic  matter,  of  a  highly  putrefiable  nature. 


GENERAL   PRINCIPLES   OF   VENTILATION.  23 

This  is  invisible  under  ordinary  circumstances,  but  is  none  the 
less  foul  and  offensive. 

The  carbonic  acid  in  expired  air  is  far  from  being  harmless, 
but  it  is  innocent  as  compared  with  these  organic  particles 
which  emanate  from  our  own  bodies.  When  the  latter  are 
not  removed  by  ventilation,  they  may  be  rebreathed,  and  thus 
instead  of  the  blood  being  purified  twice  each  minute,  it  may 
be  gradually  vitiated  and  poisoned.  Imagine  the  condition  of 
a  child  who  had  no  bath  for  six  months ;  but  uncleanliness  of 
the  skin  is  surely  of  less  importance  than  of  the  delicate 
membrane  lining  the  lungs  !  Besides,  there  is  no  such  ready 
entrance  into  the  blood  from  the  skin  as  from  the  lungs. 

If  we  were  asked  to  drink  foul  water  or  eat  decomposing 
food,  we  should  at  once  refuse,  but  we  frequently  inhale 
air  which  is  fouler  than  the  dirtiest  ditch-water,  and  nearly  as 
ofle nsive  as  a  rotten  egg ;  while  our  children  are  crowded  in 
school-rooms  in  which  they  are  forced  repeatedly  to  breathe 
their  own  and  other  children's  breaths,  to  the  sad  injury  of 
their  health. 

lots  for  Impurity  of  Air. — Perhaps  one  of  the  best  tests  for 
respiratory  impurities,  is  by  the  sense  of  smell.  It  must  be 
exercised,  however,  after  a  few  minutes'  stay  in  the  outer  air,  as 
no  sense  is  more  quickly  blunted  than  that  of  smell.  On 
entering  a  room  of  which  the  atmosphere  is  impure,  it  will  be 
found  perceptibly  stuffy  if  the  carbonic  acid  in  the  air  reaches 
6  parts  in  10,000,  and  the  degree  of  stuffiness  or  closeness  is  a 
very  fair  indication  of  the  amount  of  impurity  present.  When 
the  amount  of  carbonic  acid  reaches  10  parts  in  10,000,  the 
room  is  extremely  close. 

A  simple  chemical  test  to  ascertain  if  the  carbonic  acid 
amounts  to  6  parts  in  io,oco  of  air,  is  the  following  : — Procure 
a  bottle  holding  loi  fluid  ounces,  blow  the  air  of  the  room 
into  it  by  means  of  a  bellows,  pour  in  half-an-ounce  of  lime- 


24  SCHOOL   HYGIENE. 

water,  and  after  corking  tightly,  shake  the  bottle  well  for  two 
or  three  minutes.  If  no  visible  milkiness  is  produced  (by  the 
union  of  carbonic  acid  and  lime  forming  chalk),  then  the 
amount  of  carbonic  acid  in  the  room  is  below  6  parts  in  10,000. 

There  is  no  simple  test  for  the  organic  impurities  in  air, 
which  are  really  more  important,  because  more  pernicious,  than 
the  carbonic  acid ;  but  inasmuch  as  the  carbonic  acid  is  nearly 
always  in  exact  proportion  to  the  amount  of  organic  matter, 
the  test  for  the  former  answers  equally  well  for  the  latter. 

This  test,  combined  with  the  sense  of  smell  on  coming  direct 
from  the  external  air,  gives  most  reliable  indications,  which 
should  never  be  neglected 

Non-Respiratory  Impurities  of  Air. — Carbonic  Oxide  Gas  is 
produced  in  furnaces  and  stoves,  and  when  it  obtains  entrance 
into  a  room,  giddiness,  headache,  and  depression  of  the 
general  health  are  the  result.  Indeed,  this  gas  is  poisonous  in 
much  smaller  quantities,  and  much  more  quickly  than  the 
closely-allied  compound  carbonic  acid. 

The  use  of  coal-gas  for  lighting  purposes  is  another  common 
source  of  polluted  atmosphere.  By  the  combustion  of  i  cubic 
foot  of  coal-gas,  2  cubic  feet  of  carbonic  acid  are  produced,  and 
a  considerable  amount  of  sulphurous  acid.  A  medium  gas 
burner  burns  3  cubic  feet  of  gas  per  hour,  and  therefore  produces 
as  much  carbonic  acid  as  10  individuals  (6  cubic  feet  for  one 
gas-burner  as  compared  with  '6  cubic  feet  for  one  individual). 

Effects  of  Breathing  Impure  Air. — The  evil  effects  produced 
by  expired  air  in  a  concentrated  condition  have  been  unhappily 
proved  in  a  few  well-known  instances.  In  the  Black  Hole  at 
Calcutta,  146  persons  were  confined  in  a  space  18  feet  every 
way,  with  two  small  windows  on  one  side.  Next  morning  123 
were  found  dead,  and  the  remaining  23  were  very  ill.  It  mu^t 
not  be  supposed,  however,  that  no  ill  results  follow  a  com- 
paratively small  degree  of  pollution,  because  these  results  are 


GENERAL   PRINCIPLES   OF   VENTILATION.  25 

not  immediately  apparent.  A  general  lowering  of  strength  and 
vigour  is  produced,  and  a  greater  proneness  to  fall  victim  to 
respiratory  and  other  diseases.  The  drowsiness  and  languor  so 
frequently  noticeable  in  school-children  are,  to  the  intelligent 
teacher,  not  an  indication  of  wilful  inattention,  but  of  the 
necessity  for  a  purer  air.  Yawning,  again,  is  a  cry  of  the 
nervous  system  for  purer  blood,  />.,  for  blood  containing  more 
oxygen  and  less  effete  matters. 

It  is  in  the  highest  degree  unfair  to  expect  the  brains  of 
children  to  be  in  active  exercise  of  their  functions,  while  they 
are  provided  with  blood  which  is  vitiated  by  respiratory 
impurities,  and  are  thus  kept  in  a  species  of  mental  fog. 

Children  are  especially  susceptible  to  the  dangers  resulting 
from  impure  air.  They  are  necessarily  somewhat  closely 
massed  together,  and  the  organic  matters  hanging  about  the 
room  serve  as  a  favourable  soil  for  the  propagation  and 
development  of  infectious  diseases,  which  in  a  pure  air  would 
soon  lose  their  vitality.  In  this  way  diphtheria,  scarlet  fever, 
and  like  diseases  are  not  uncommonly  propagated  at  school. 
Tubercular  consumption,  again,  has  been  clearly  shown  to  be 
greatly  favoured  by  over-crowding,  and  it  is  not  impossible 
that  its  propagation  from  one  child  to  another  under  such 
conditions  does  sometimes  occur.  In  the  case  of  rabbits  and 
guinea-pigs,  it  is  found  that  when  they  are  kept  in  a  small, 
close  apartment  for  three  months,  tubercular  disease  is  produced, 
and  dogs  under  similar  circumstances  become  consumptive. 

Ttmptrature  of  Air  required. — The  external  temperature 
varies  greatly  with  the  season,  and  even  at  different  parts  of 
the  same  day.  In  Philadelphia  the  averages  of  ten  years 
show  that  the  mean  temperature  in  the  winter  months  is  33.2° 
Fahr.,  in  spring  51.9°,  in  summer  76.1°,  in  autumn  55.7°.  Now, 
the  admission  of  air  at  76°  Fahr.  makes  a  room  uncomfortably 
warm,  while  the  temperature  of  32°  could  hardly  be  borne  by 


26  SCHOOL   HYGIENE. 

the  most  robust  of  children.      In  one  case,  the  entering  aii 
may  with  advantage  be  cooled  ;  in  the  other,  it  must  be  warmed. 

The  temperature  of  each  class-room  should  vary  between 
65°  and  70°  Fahr.  In  infant-schools  the  upper  limit  of  70°  is 
preferable;-  Possibly  a  little  higher  than  this  would  do  no 
harm,  but  the  heat-generating  powers  of  the  body  are  thus 
lowered,  and  the  air  is  more  likely  to  be  vitiated. 

Where  hot-air  or  hot-water  apparatus  is  the  source  of  heat, 
a  common  experience  is  to  begin  the  day  in  school  with  a 
temperature  of  60°  ;  but  in  a  few  hours,  owing  to  deficient  exit 
of  impure  air,  and  to  the  heat  produced  by  the  children  them- 
selves, f'ie  temperature  has  reached  70^  or  even  80°  without 
being  noticed,  and  now  the  children  feel  no  warmer  than  when 
the  thermometer  stood  at  60°.  The  excessive  heat  has  pro- 
duced a  general  languor  of  the  circulation,  and  a  dilated 
condition  of  the  cutaneous  blood-vessels,  leading  to  a  general 
lack  of  tone  and  vigour.  For  a  similar  reason  the  mental 
powers  flag,  and  sleepiness  is  induced.  Persons  coming  into 
the  room  from  out-of-doors  find  the  atmosphere  intolerable, 
but  the  occupants,  unfortunately,  cannot  judge  for  themselves. 
It  is  important  that  thermometers  should  be  placed  in  con- 
spicuous places  in,  ifoomiS  (remote  from  the  point  of  entry  o(. 
hot  air),  and  that  their  indication  should  be  hourly  ascertained. 
The  remedy  for  a  hot  and  close  room,  is  not  to  stop  the  further 
entry  of  warm  fresh  airk  but  to,  secure  a  freer  escape  of  hot 
impure  air. 

Children,  in  the  perspiring  ana  low-toned  condition  produced 
by  an  over-heated  room,  are  allowed  to  rush  out  into  the  cold 
corridors  or  offices  of  the  school ;  and  it  is  little  wonder  that 
quinsy,  croup,  bronchitis>  and  other  troubles  are  frequently 
induced.  The  use  of  an  alarm-thermometer,  which  would 
ring  a  bell  as  long  as  the  temperature  remained  above  70°, 
would  be  very  valuable.* 


GENERAL   PRINCIPLES    OF   VENTILATION.  27 

Dryti(ss  of  Air. — All  air  contains  water  in  a  gar.eous  con- 
dition, and  the  hotter  the  air  the  more  water  it  will  contain 
before  the  point  of  saturation  is  reached.  For  every  increase 
of  27°  in  temperature,  air  doubles  its  capacity  for  holding  water. 
The  warm  air  supplied  to  school-rooms  from  heating  appliances 
is  often  very  dry.  It  then  tends  to  abstract  moisture  from  the 
skin  and  lungs,  and  produce  a  dry  feverish  condition,  which 
is  frequently  noticeable  in  rooms  heated  by  furnace  or  stove. 
A  pail  of  water  standing  in  the  room,  near  the  source  of  heat, 
helps  to  prevent  this.  It  is  doubtful  whether,  in  many  cases, 
the  effects  ascribed  to  dry  ness  of  air  are  not  really  due  to 
escape  of  the  products  of  combustion,  such  as  carbonic  oxide 
and  sulphurous  acid. 

Amount  of  Air  Required. — The  limit  of  impurity  of  air 
beyond  which  it  becomes  perceptibly  stuffy  is  -06  per  cent.,  or 
6  parts  in  10,000.  In  order  to  maintain  the  carbonic  acid  at 
this  level,  3,000  cubic  feet  of  pure  air  are  required  per  hour  by 
every  adult,  and  more  than  half  as  much  should  be  furnished 
for  each  scholar.  This  might  be  furnished  by  a  large  room 
with  a  slow  circulation  ot  air,  or  a  small  room  with  a  rapid 
circulation  of  air.  In  a  school-room  the  amount  of  space  per 
child  is  necessarily  limited  ;  this  must  therefore  be  compensa- 
ted for  by  a  more  frequent  change  of  air. 

The  English  Educational  Department  give  80  cubic  feet  as 
the  minimum  space  per  scholar,  and  8  square  feet  as  the  mini- 
mum floor-space  allowable.  Under  the  London  School  Board, 
eight  square  feet  per  scholar  are  enforced  in  infant-schools. 
In  senior  schools  the  floor-sj  ace  is  calculated  upon  seat  ac- 
commodation. This  ensures  on  the  whole  slightly  over  10 
square  feet  of  floor-space  per  child. 

We  may  practically  fix  the  permissible  carbonic  acid  in  the 
atmosphere  of  school-rooms  as  i  part  in  1,000,  instead  of  the 
ideal  limit  of  *6  per  1,000 ;  as  it  is  doubtful  if,  with  the  15  square 


28  SCHOOL    HYGIENE. 

tain  1,500  cubic  feet  of  air  per  hour,  it  is  evident  that  the  air 
must  be  replaced  at  least  every  six  minutes,  i.e.,  10  times  in  an 
hour. 

To  recapitulate  :  the  requirements  of  each  class-room  in  a 
school  building  should  not  be  less  than  15  square  feet  of 
floor-area  per  pupil,  and  the  window-space  should  equal  one- 
fourth  of  the  floor-space.  Each  pupil  should  be  provided  witli 
25  to  30  cubic  feet  of  fresh  air  per  minute,  introduced  and  dis- 
tributed without  producing  unpleasant  draughts  and  having  a 
temperature  of  from  60°  to  65°  Fahr. 

The  above  represents  the  minimum  of  requirement  *br  cold 
weather.  In  warm  weather,  as  much  fresh  air  must  be  intro- 
duced as  open  windows  and  doors  will  admit. 

A  fallacy  frequently  entertained  is  that  deficiencies  in  floor- 
space  may  be  compensated  by  a  lofty  ceiling.  Such  is  not  the 
case,  however.  A  "lofty"  room  is  not  necessarily  "airy." 
Any  height  above  12  feet  has  little  or  no  influence  on  the" 
purity  of  the  lower  atmosphere  in  which  the  children  have  to 
live  ;  and  cross- ventilation  at  a  considerable  height  may  leave 
the  atmosphere  of  the  lower  level  in  which  children  breathe  in 
a  vitiated  condition.  It  is  not  advisable  to  have  school-rooms 
much  higher  than  the  windows,  as  warm  and  impure  air  tends 
to  accumulate  along  the  ceiling,  subsequently  falling  to  the 
floor-level  as  it  cools. 


CHAPTER  VI. 

NATURAL  VENTILATION. 

Rules  respecting  Ventilation.  —  Natural  and  Artificial  Ven- 
tilation.—Ventilation  through  Window,  Wall,  Chimney,  ana 
Ceiling. 

MOST  treatises  on  ventilation  and  heating  have  been  founded 
on  European  facts  and  figures,  and  are  hence  unreliable  for  the 
American  climate.  And  even  in  speaking  of  the  States  alone, 
it  is  difficult  to  give  general  methods  which  shall  be  applicable 
to  the  great  diversities  of  climate  includ  d  in  its  25°  of  latitude, 
of  which  the  only  one  feature  in  common  is  the  inconstancy 
of  the  climate.  New  York,  for  instance,  has  been  said  to  have 
the  summer  of  Rome,  and  the  winter  of  Copenhagen. 

Ventilation  is  constantly  being  produced  by  two  natural 
agencies,  viz.,  the  diffusion  of  gases,  and  the  movements 
caused  by  differences  of  temperature. 

Diffusion,  by  which  the  purer  outside  gases  tend  to  mix 
with  the  impure  internal  air,  is  constantly  going  on,  thougn 
the  rate  of  diffusion  is  under  ordinary  circumstances  slow  and 
the  amount  of  interchange  thus  effected  is  but  small. 

Differences  of  temperature  cause  much  more  active  move- 
ments of  air,  warm  air  floating  to  the  top  of  cold  air,  as  oil  floats 
to  the  top  of  water.  The  air  in  a  room  is  warmed  by  the  in- 
mates and  by  the  stove,  gas,  or  other  source  of  artificial  heat. 
Cold  air  tends  to  rush  in  from  every  opening,  and,  being 
29 


30  SCHOOL   HYGIENE. 

heavier  than  warm  air,  falls  toward  the  floor,  producing  a 
draught.  The  great  problem  of  ventilation  is  to  secure  a 
sufficient  interchange  of  air  without  causing  draughts.  The 
entrance  of  air  at  any  temperature  below  50°  into  a  room 
whose  temperature  is  65°  or  even  70°  is  almost  certain  to  be 
accompanied  by  draught ;  hence  it  is  necessary  to  warm  the 
entering  air  during  many  of  the  winter  months. 

If  a  free  entrance  for  pure  air  is  not  provided,  the  influence 
of  the  higher  temperature  in  the  school-room  may  produce  an 
aspiration  of  air  from  undesirable  places.  Thus  it  not  un- 
commonly happens  that  air  is  drawn  from  underground  cellars, 
defective  drains,  water-closets,  &c. 

The  following  rules  respecting  ventilation  are  of  importance  : 

(i.)     The  air  should  be  drawn  from  a  pure  source. 

(2.)  No  draught  or  current  should  be  perceptible.  Very  often 
the  remedy  for  a  draught  is  not  to  close  the  opening,  but  to 
make  others  in  order  to  increase  the  area  through  which  air  enters. 

(3.)     The  entry  of  air  should  be  constant,  not  at  intervals. 

(4.)  An  abundant  exit  for  impure  air  should  be  provided 
separate  from  the  points  of  entrance  of  fresh  air.  In  order  to 
maintain  a  given  standard  of  purity,  it  is  necessary  to  provide  for 
the  removal  of  as  much  impure  air  as  is  supplied  of  pure  air. 

Ventilation  is  of  two  kinds,  natural  and  artificial.  The  first 
kind  is  produced  by  the  ordinary  interchange  of  air  when 
windows  or  doors  are  allowed  to  remain  open.  Artificial  ven- 
tilation is  that  produced  by  the  extraneous  help  of  heating 
apparatus  or  of  mechanical  appliances  for  propelling  the  air 
into  a  room  or  aspirating  it  from  it. 

Such  mechanical  measures  are  not  practically  useful  for 
school-rooms,  and  we  shall  confine  ourselves  to  the  considera- 
tion of  ventilation  by  natural  means  and  by  heating  apparatus. 

Natural  Ventilation  is  possible  as  an  exclusive  plan  only 
during  the  summer  months.  In  colder  weather  the  admission 


NATURAL  VENTILATION.  31 

of  external  air  produces  violent  draughts.  Any  reliance  on  it  as 
the  source  of  pure  air  is  practically  found  to  end  in  the  careful 
closure  of  all  windows,  doors,  and  ventilating  apertures,  and  a 
resulting  foulness  of  atmosphere  which  is  only  too  common  in 
school-rooms. 

When  the  external  temperature  reaches  60°,  or  better  still 
65°,  the  air  may  be  freely  admitted.  Open  windows  are  by  far 
the  best  means  of  ventilation,  and  during  the  school  recess 
all  the  windows  should  be  thrown  open,  opposite  windows  if 
possible  or  doors  and  windows,  in  order  that  the  rooms  may 
be  thoroughly  flushed  with  air.  Ordinary  ventilation  commonly 
leaves  a  considerable  proportion  of  organic  volatile  matter 
from  respiration  hanging  about  the  room,  while  the  rapid 
currents  of  air  during  the  flushing  of  a  room  carry  this  away. 

The  eccurrence  of  any  down-draught  from  an  open  window 
may  be  prevented  by  having  its  upper  segment  made  to  work  on 
a  hinge,  lateral  triangular  pieces  of  glass  being  inserted  on  each 
side  of  the  window  (Fig.  4)  ;  or  a  narrow  piece  of  wood  may  be 


4. — Diagram  of  ventilation  by  hinged  window*. 


OP 


.  03r  .  *  v. 


SCHOOL   HYGIENE. 


inserted  under  the  lower  sash  of  the  window,  an  upward  cur- 
rent of  air  being  thus  allowed  between  the  two  sashes.  (Fig.  5.) 


FIG.  5. — Ventilation  between  window-sashes,  a  block  being  fitted  under 
the  lower  sash. 

Sometimes  the  top  sash  is  opened  and  wire  gauze  is  fastened 
across,  but  by  this  plan  the  amount  of  air  which  enters  is  much 
less  than  through  a  continuous  opening  of  the  same  area. 

The  ivall  may  be  utilised  for  ventilating  purposes  by  the  in- 
sertion of  a  grating  near  the  floor  which  is  connected  on  its 
inner  aspect  to  a  vertical  tube,  an  upward  direction  being  thus 
given  to  the  entering  air.  (Fig.  6  )  Or  the  grating  may  be  placed 


NATURAL   VENTILATION. 


33 


higher  up,  a  movable  valve  on  the  inner  side  of  the  wall  direct- 
ing the  current  upwards.     (Fig.  7.) 


\J\\ 


FIG.  6.— Diagram  showin 


ig  ventilation  by  Tobin'S  tube, 
from  centre-flower  of  ceiling. 


and  an  exit-shaft  leading 


FIG.  7.— Sheringham's  ventilator. 

The  ventilation  is  much  more  likely  to  be  successful  if  there 
are  openings  on  opposite  sides  of  the  room,  or  if  there  is  a 
chimney  or  other  draught-corn peller,  in  the  school-room. 

Indeed  a  chimney  should  always  be  allowed  for  each  room, 
even  when  it  is  not  contemplated  to  have  open  fires.  Owing 


34 


to  the  aspirating  effect  of  winds  acting  at  the  top  of  the  chim- 
ney, there  is  generally  an  up-current,  and  always  so  if  there  is 
free  ingress  of  air  by  doors  or  windows.  The  action  of  the 
chimney  in  withdrawing  impure  air  from  a  room,  may  be 
greatly  increased  by  narrowing  its  two  ends,  so  as  to  produce  a 
more  rapid  current  at  the  entrance  and  exit  of  air. 

Flap's  or  Arnott's  valves  (Fig.  8)  placed  above  the  fire- 
place and  opening  into  the  flue,  are  of  some  service  in  with- 
drawing hot  impure  air  collected  near  the  ceiling,  though  the 
extent  of  their  value  must  not  be  over-estimated,  as  the  amount 
of  air  passing  through  them  is,  on  account  of  their  size,  neces- 
sarily limited. 


FIG  8.— Boyle's  mica-flap  ventilator. 
«,  View  from  room.  b,  View  from  chimney. 

The  ceiling  may  be  utilised  for  carrying  off  foul  air,  and  as 
the  foul  air  from  respiration  is  warm,  it  rises  to  the  top  of  the 
room,  .and  may  with  advantage  be  at  once  removed. 

A  grating  in  the  external  wall  may  be  made  to  correspond 
to  the  space  between  the  ceiling  and  the  floor  of  the  room 
next  above,  and  apertures  in  the  ceiling  made  to  communicate 
with  this.  (Fig.  6.)  Or  an  air-tight  zinc  chamber  between  the 
ceiling  and  the  room  above  may  be  carried,  by  means  of  a  zinc 
pipe,  into  the  chimney,  the  junction  with  the  latter  being  guarded 
by  a  valve  working  only  in  one  direction. 

The  use  of  ventilating  gas-burners  should  always  be  en 
forced,  the  products  of  the  combustion  of  gas  being  thus  at 
once  removed,  and  at  the  same  time  much  impure  air  from 


NATURAL   VENTILATION.  35 

the  room.  (Fig  3,  page  20.)  It  is  important,  however,  that 
children  should  not  work  in  a  room  where  gas  is  required  during 
the  day,  and  that  their  evening  studies  should  be  very  short. 

In  •rder  that  natural  ventilation  may  be  more  effectual,  all 
corridors  should  be  large  and  airy,  and  have  windows  opening 
direct  to  the  outer  air.  No  school-plan  which  does  not  fulfil 
these  conditions  can  be  regarded  as  satisfactory. 

In  the  methods  of  ventilation  hitherto  described,  the  air  is 
admitted  at  the  same  temperature  as  the  external  air.  Such 
methods  have,  however,  but  a  limited  application  in  the 
States.  During  a  large  portion  of  the  year,  in  order  to  pre- 
vent dangerous  draughts,  the  incoming  air  requires  warming. 
TKe  means  by  which  the  incoming  air  can  be  warmed  will  be 
discussed  in  the  next  chapter. 


CHAPTER  VII. 
VENTILATION  AND  WARMING. 

Difficulties  oj  Successful  Ventilation  by  Warm  Air.— Open  Fire- 
place.-Heating  by  Gas.— Closed  Stoves. -Central  System  of 
Heating. — Hot- Air  Ftirnaces. — Steam  Apparatus.  —  Hot-  H  ater 
Apparatus.— Entrance  Flues  and  Extraction  Shafts. — 7 'he 
Bridgeport  System. 

A  DOUBLE  heading  has  been  purposely  made  to  this  chapter. 
In  fact,  ventilation  and  warming,  to  be  in  accordance  with  the 
laws  of  health,  always  require  to  be  conjointly  considered.  A 
successful  system  of  warming  a  school  must  necessarily,  for 
purposes  of  health,  provide  pure  air ;  and  a  successful  system 
of  ventilation  must,  at  least  in  the  winter  months,  also  furnish 
warmth. 

These  considerations  bring  us  face  to  face  with  the  serious 
question  of  expense.  The  warming  of  a  large  volume  of  air 
means  the  expenditure  of  coal  or  gas,  and  ventilation  means 
the  discharge  of  this  warmed  and  therefore  expensive  air  as  soon 
as  it  becomes  impure.  If,  in  order  to  diminish  expense,  no 
provision  is  made  for  the  escape  of  the  warm  air  as  it  becomes 
polluted,  the  school-room  speedily  becomes  foul  and  unhealthy, 
• — a  very  hot-bed  of  disease. 

When  the  necessary  expcnsiveness  of  ventilation  is  fairly 
grasped  by  school-managers,  surely  there  will  be  an  end  of  the 
economising  over  ventilation  which  is  now  so  general.  Such 
economising  is  most  certainly  at  the  expense  of  the  children's 
health,  and  tends  yearly  to  greatly  increase  our  bill  of  mortality. 


TION    AND  WARMING. 


_  _/*  -v**-«£~~'-»*v     '  r***-**?-  .OL~4**r*^f*c-*^.   * 

/      No  system  of  warming  and  ventilation  has  been  devised 

I   which   will   work  automatically  without  the  supervision  of  a 

I   competent  officer.     Brains  are  required  as  well  as  coal  and  an 

\     apparatus  for  this  purpose  ;  a  watchful  and  intelligent  super- 

vision to  see  that  the  temperature  and  the  ingress  and  egress 

1    of  air  are  properly  adjusted. 

V  The  school-keeper,  who  is  generally  responsible  for  the 
maintenance  of  hot-air  apparatus,  not  uncommonly  regards 
ventilation  as  inimical  to  his  interests,  and  will,  in  case  the 
heat  is  lowered,  stop  the  valves  leading  to  the  exit-flues,  thus* 
penning  up  the  hot  impure  air,  rather  than  apply  the  extra  fuel 
required.  It  is  to  his  interest  to  appear  economical  of  coal  ; 
he  is,  therefore,  under  the  constant  temptation  to  check  the 
outflow  of  warm  air  from  the  rooms,  and  to  minimise  the 
period  of  flushing  them  with  external  air  after  school  hours. 

The  system  of  warm  air  ventilation  to  be  used  will  vary 
with  the  size  of  the  school  and  with  local  conditions.  For 
small  schools  some  of  the  following  plans  may  be  adopted, 
though  in  large  schools  a  central  system  is  the  best. 

The  Open  Fire-ptace  not  only  furnishes  a  cheerful  warmth,  but 
is  likewise  a  valuable  purifier  of  the  atmosphere  of  a  room,  as 
from  14,000  to  20,000  cubic  feet  of  air  pass  up  an  ordinary 
chimney  each  hour.  Thus,  reckoning  1,500  cubic  feet  for 
each  scholar,  the  respiratory  impurities  of  from  9  to  13 
scholars  can  be  got  rid  of  in  this  way.  The  open  fire-place, 
however,  does  not  form  a  convenient  source  of  heat  except  for 
small  rooms,  for  the  following  reasons  :  —  (i)  The  heat  is  un- 
equally distributed,  being,  for  instance,  9  times  as  great  at  a 
distance  of  one  foot  from  the  fire  as  it  is  at  a  distance  of  3  feet. 
(2)  Currents  of  cold  air  are  produced  along  the  floor  in  order 
to  supply  the  place  of  the  air  which  is  rushing  up  the  chimney. 
These  are  very  trying  unless  a  free  supply  of  warm  air  from 
some  other  source  than  the  fire  is  allowed.  (3)  There  is  the 


SCHOOL    HYGIENE. 


trouble  of  frequently  replenishing  the  fire,  interfering  with 
studies. 

The  great  loss  of  heat  necessarily  involved  in  an  open  fire- 
place has  led  to  the  use  of  chambers  behind  the  fire-place,  by 
which  external  air  is  warmed  as  it  enters  the  room.  A  stove 
constructed  on  this  principle  is  shown  in  Fig.  9.  At  the  back 
of  the  stove  is  an  air-chamber  communicating  with  the  external 
air. 

Air  admitted  through  the  opening  (a,  Fig.  9)  is  warmed  by 
coming  in  contact  with  the  fire-clay  (d),  which  separates  the  air- 
channel  from  the  smoke  flue  (c).  The  warmed  air  leaves  the 
air- channel  by  the  grating  (b)  over  the  fire-place,  and  then 
travels  along  the  upper  part  of  the  room,  falling  to  the  floor  as 
it  cools  and  finally  escaping  up  the  chimney. 


FTG.  9. — Slow-combustion  ventilating  stove. 
I. — Section  of  stove,  showing—  a,  entrance   of  cold  air ;  b,  entrance  of 

warmed  air  into  room  ;   c ,  smoke-flue ;   dt  fireclay  back  of  stove. 
8. — Front  elevation  of  same  stove. 


VENTILATION   AND   WARMING.  39 

Gas  is  sometimes  employed  instead  of  coal  for  fires. 

No  gas-stove  should  be  allowed  in  which  provision  is  not 
made  for  carrying  off  all  the  products  of  combustion.  A 
chimney  or  pipe  for  carrying  away  the  gases  produced  is  even 
more  necessary  than  in  the  case  of  a  coal-fire,  for  in  the  latter 
case  the  smoke  produced  would  necessitate  a  recourse  to  open 
windows  or  other  means  of  ventilation,  while  in  the  former  the 
deleterious  products  are  invisible.  Gas  is  suitable  as  a  means 
of  heating  only  small  rooms,  owing  to  its  greater  expense. 
Several  stoves  are  convenient  and  thoroughly  sanitary ;  they 
are  placed  in  an  open  fire-place  with  a  flue-pipe  attached.  For 
schoul-rooms  where  gas  is,  for  special  reasons,  employed  as  the 
heating  agent,  the  Calorigen  stove  is  a  valuable  means  of 
supplying  warm  and  pure  air.  Us  arrangement  is  shown 
in  Fig.  10.  A  spiral  tube  communicates  below  with  the 


FK2.  io.— The  Calorigen  stove. 


40  SCHOOL    HYGIENE. 

external  air,  and  opens  at  its  upper  end  into  the  room.  A 
small  gas-flame  is  kept  burning  below  the  spiral  tube,  the  pro- 
ducts of  combustion  from  which  are  carried  directly  out-of- 
doors.  The  heat  thus  produced  warms  the  air  which  is 
passing  along  the  spiral  tube  and  causes  a  constant  rapid  entry 
of  warm  air  into  the  room. 

Closed  Stoves  are  useful  chiefly  in  small  school-rooms,  either 
gas  or  coal  being  burnt.  They  possess  the  advantage  over  an 
open  fire-place,\hat  there  is  a  smaller  consumption  of  fueUand 
that  the  combustion  can  be  more  effectually  regulated. 
Commonly,  however,  they  make  the  air  of  a  room  dry,  and 
produce  a  peculiar  close  smell,  probably  owing  to  the  charring 
of  minute  organic  particles.  It  is  found  also  that  carbonic 
oxide  may  pass  through  cracks  or  even  through  the  substance 
of  iron  stoves,  when  they  are  red-hot.  When  stoves  are 
employed,  firebrick  should  be  everywhere  in  contact  with  the 
fire,  and  the  stove  should  never  be  allowed  to  become  red-hot. 
There  should  be  as  few  joints  as  possible,  and  these  should  be 
horizontal  and  not  vertical.  The  supply  of  air  to  the  stove 
should  never  be  cut  off,  nor  should  the  escape  of  the 
products  of  combustion  be  prevented  by  dampers,  or  by 
admitting  air  between  the  stove  and  the  chimney. 

We  are  strongly  of  opinion  that  stoves  should  be  allowed 
only  in  combination  with  some  provision  for  warming  the  in- 
coming air.  This  may  be  secured  by  having  a  sheet  iron  or 
zinc  cylinder,  considerably  wider  than  the  stove-pipe,  placed 
round  it  and  fastened  to  the  floor  below.  A  good-sized  pipe  is 
then  carried  through  the  floor  and  out  to  the  external  wall  of 
the  school.  In  this  way  a  large  supply  of  warmed  air  is 
drawn  into  the  room  (Fig.  n).  Similarly  the  stove-pipe  n?ay 
be  utilised  by  enclosing  it  in  another  pipe,  which  starts  some 
distance  from  the  stove,  and  is  carried  into  the  chimney.  This 
causes  the  abstraction  of  considerable  impure  air.  If  required. 


VENTILATION   AND   WARMING.  41 

impure  air  may  be  withdrawn  from  the  next  room  below  by  a 
modification  of  this  method. 


FIG.  ii. — '  losed  stove  arranged  to  warm  incoming  fresh-air. 

Central System  of Heating.— -Hot  air,  steam,  and  hot  water 
are  the  usual  sources  of  heat  employed,  and  each  plan  will 
require  consideration. 

The  great  majority  of  Hot-air  Furnaces  are  unsatisfactory 
for  several  reasons. — (i.)  The  furnace  is  generally  too  small ; 
consequently,  in  severely  cold  weather,  the  radiating  surfaces 
are  unduly  heated  and  the  joints  may  be  loosened.  Carbonic 
oxide  and  sulphurous  acid  may  then  escape,  the  latter  being 
fortunately  irritant,  but  the  former  odourless  and  recognised 
only  by  the  giddiness,  languor,  and  peculiar  discomfort 


4»  SCHOOL  HYGIENE. 

produced.  Carbonic  oxide  will  pass  through  red-hot  cast-iron, 
but  the  danger  from  the  sand-holes  produced  in  defective 
casting,  or  from  badly-fitting  joints,  is  probably  much  greater. 
Wrought-iron  furnaces  do  not  allow  the  escape  of  carbonic 
oxide  through  their  substance,  but  the  joints  may  crack  ;  and 
wrought-iron  oxidises  more  rapidly  than  cast-iron. 

(2.}  No  provision  is  made  for  mixing  cool  with  the  heated 
air,  which  is  often  distributed  at  140°.  To  cool  the  room  the 
register  is  shut  off,  the  poor  scholars  being  then  obliged  to  re- 
breathe  the  same  atmosphere  repeatedly. 

(3.)  The  source  of  the  air  supply  to  the  furnace  is  often 
most  unsatisfactory.  The  furnace-room  may  contain  decom- 
posing vegetables  or  an  empty  bell  trap  leading  to  a  defective 
drain  or  a  water-closet,  none  of  which  increase  the  purity  of 
the  school  atmosphere.  If  the  furnace-room  is  underground, 
it  is  not  infrequently  kept  closed,  and  then  the  air  which  is 
warmed  may  be  the  air  already  breathed  by  the  scholars,  and 
subsequently  drawn  down  into  the  cellar.  A  large  furnace 
is  best,  as  it  never  needs  to  be  made  red-hot.  It  should  have 
the  fewest  joints  and  the  largest  amount  of  radiating-sur- 
face,  in  proportion  to  the  size  of  the  fire-box,  that  can  be 
secured. 

Steam  Apparatus  is  perhaps  more  frequently  used  than  any 
other  in  the  United  States  ;  and  it  offers  such  great  advantages, 
that  it  is  to  be  regretted  that  it  is  not  more  frequently  used  in  other 
countries.  It  is  much  more  easily  made  to  work  and  is  cheaper 
than  hot-water  apparatus,  and  there  is  less  difficulty  in  planning 
it.  Also  the  radiating  surfaces,  being  at  a  higher  temperature 
than  with  hot  water,  may  be  made  smaller  and  more  compact. 

Its  chief  disadvantages  are  that  (i)  constant  attention  is 
required  to  keep  up  the  supply  of  heat,  as  the  radiating  sur- 
faces cool  much  more  rapidly  than  hot-water  apparatus. 
(2)  The  radiators  being  at  a  very  high  temperature  it  is  diffi- 


VENTILATION    AND   WARMING.  43 

cult  to  regulate  the  supply  of  heat  in  accordance  with  the  out- 
door temperature. 

This  may  be  remedied  by  arranging  each  set  of  radiators  in 
several  different  sections,  in  each  of  which  the  flow  of  steam 
can  be  regulated  independently  of  the  others.  Or  the  air 
ducts  and  flues  may  be  so  arranged  that  by  movement  of  a 
valve  the  air  can  be  made  to  pass  wholly  in  contact  with  the 
radiating  surfaces  or  separate  from  them  in  any  proportion. 
Such  a  plan  requiries  the  superintendence  of  a  skilled 
attendant. 

Hot-water  Apparatus  possesses  some  advantages  over  steam- 
apparatus,  in  the  facts  that  the  air  passing  over  hot-water  pipes 
is  as  a  rule  not  raised  above  100°  F.,  with  a  temperature  of  the 
pipes  of  from  160-180°,  and  that  hot  water  continues  to  cir- 
culate some  time  after  the  fire  is  extinguished. 

We  shall  mention  only  to  condemn  the  system  of  "  Direct 
Radiation"  in  which  steam-pipes  are  placed  in  a  room  without 
any  provision  for  the  entry  of  warmed  air.  This  has  been 
well  described  as  "  one  of  the  most  killing  systems  in  exist- 
ence." The  use  of  hot-water  pipes  (apart  from  arrangements 
for  ventilation),  whether  on  the  low-pressure  or  high -pressure 
system,  is  similarly  to  be  condemned.  In  every  case  provision 
should  be  made  for  passing  the  cold  external  air  over  the  pipes 
as  it  enters  the  room. 

In  discussing  the  preceding  systems  of  warming,  we  have 
assumed  that  warmed  air  is  admitted  in  amount  proportionate 
to  the  number  of  scholars.  Each  scholar  requiries  1,500 
cubic  feet  of  air  per  hour  ;  therefore,  assuming  the  space  per 
head  as  150  cubic  feet,  it  follows  that  the  air  of  the  room  must 
be  replenished  every  6  minutes.  At  the  same  time  an  equal 
(or  slightly  larger)  amount  of  air  must  be  removed  to  make 
way  for  the  pure  air. 

Suppose  we  have  to  arrange  for  a  school  with  from  8  to  is 


44  SCHOOL   HYGIENE. 

class-rooms,  each  with  40  to  60  pupils,  and  that  these  are  in 
connection  with  a  large  central  hall  in  a  two-story  brick  build- 
ing. Ordinarily,  architects  concern  themselves  entirely  with 
the  provision  of  extraction-shafts  for  foul  air,  trusting  for  pure 
air  to  what  can  enter  through  slits  in  the  window-sills,  &c., 
while  the  heating-apparatus  is  apart  from  any  ventilation. 

The  provision  of  these  extraction -shafts  is  of  great  import- 
ance, and  we  may  consider  them  first.  As  a  rule  there  should 
be  an  aspirating  shaft  or  chimney  on  each  side  of  the  central 
hall.  A  room  containing  50  scholars,  should  discharge  2<t 
cubic  feet  of  air  per  second  ;  a  flue  carrying  air  with  a  velocity 
of  6  feet  per  second  should  therefore  be  2  feet  square,  exclusive 
of  the  space  allowed  for  smoke-flue  or  other  heating  apparatus. 
(Dr.  Billings.)  Such  extraction,  however,  without  the  provi- 
sion of  warm  pure  air  to  take  its  place,  is  never  satisfactory. 
The  vis  a  tergo  as  well  as  the  vis  afronte  is  required  in  order  to 
maintain  a  pure  atmosphere.  The  system  adopted  at  the  High 
School,  Bridgeport,  Connecticut,  is  one  of  the  most  successful 
and  complete  hitherto  adopted,  as  it  fulfils  all  the  requirements 
of  school  ventilation  and  warming.  (For  details  see  3rd 
Annual  Report  of  Connecticut  State  Board  of  Health.) 

In  this  system  the  coil  boxes  heated  by  steam  are  placed 
on  the  inner  wall,  extensive  piping  being  thus  saved  and  the 
danger  of  freezing  obviated.  Fresh  air  is  passed  through  the 
coil-chambers  and  conveyed  to  the  rooms  by  metallic  flues 
entering  the  inner  wall  about  8  feet  from  the  floor.  Thence  it 
diffuses  itself  along  the  walls  and  ceiling,  passing  down  the 
opposite  wall  and  returning  at  a  lower  level  to  the  flue  for  exit 
of  impure  air,  which  is  placed  under  a  platform  measuring  6  by 
12  feet  on  movable  castors  and  on  the  same  side  of  the  room 
as  the  introduction-flue. 

Careful  experiments  have  shown  that  no  other  relative  posi- 
tion of  entrance  and  exit  flues  ensures  so  thorough  and  equable 


VENTILATION   AND   WARMING.  45 

a  warming  of  the  room,  and  replenishing  of  its  atmosphere. 
The  entire  lower  edge  of  the  platform  is  4  inches  from  the 
floor,  to  allow  full  circulation  of  air  under  it. 

In  order  that  a  strong  up-current  may  be  constantly  ensured 
in  the  foul-air  shafts,  other  coils  are  placed  in  them,  and  the 
entrance  and  boiler  flues  are  also  made  to  pass  through  the 
foul-air  shafts,  of  course  without  any  communication.  The 
foul-air  or  extraction  shafts  should  never  be  placed  in  the 
outer  wall  if  possible,  owing  to  the  defective  up-current  from 
loss  of  heat.  If  such  an  arrangement  cannot  be  avoided,  the 
loss  of  heat  maybe  diminished  by  a  double  wall  and  air  space. 

The  difficulty  of  regulating  the  temperature  of  the  rooms 
without  closing  the  registers  has  been  overcome  in  the  Bridge- 
port School-house,  by  enclosing  the  heating  surface  for  each 
room  in  a  separate  jacket  of  metal  and  then  subdividing  ic 
into  five  sections,  so  arranged  that  any  number  may  be  used 
or  cut  off  at  pleasure,  the  supply  of  pure  air  remaining  always 
the  same. 


CHAPTER  VIII. 

DRAINAGE  ARRANGEMENTS. 

Lavatories.  —  Urinals.  —  Water-closets.  —  Soil-pipe.  —  Drains.— 
Earth-closets. 

THE  school  premises  should  always  be  so  placed  that  there  is 
a  fall  from  them  capable  of  being  utilised  for  drainage.  A  site 
without  means  of  drainage  is  not  worth  having  at  any  price. 

Lavatories  should  be  kept  strictly  clean,  and  the  waste-pipes 
not  allowed  to  run  directly  into  the  drain,  but  trapped,  with  a 
fresh-air  inlet  on  the  house  side  of  the  trap.  In  one  case,  the 
writer  distinctly  traced  an  outbreak  of  typhoid  fever  in  a  school 
to  the  direct  connection  of  the  lavatory-waste  with  a  Mansergh's 
trap,  the  arrangement  of  which  had  been  inverted  by  an 
ignorant  workman.  In  cold  climates,  disconnection,  on  the 
English  system,  is  impracticable.  It  is  well  to  remember  that 
sometimes  the  overflow-pipes  from  wash-basins  are  connected 
with  the  drain,  even  when  the  waste-pipes  are  properly  dis- 
connected. An  offensive  smell  may  arise  from  decomposing 
soap  in  lavatory  waste-pipes ;  hence,  when  several  basins  are 
connected  with  a  common  waste-pipe,  the  angles  of  junction 
should  be  very  obtuse.  In  addition,  the  waste-pipe  from  each 
basin  should  have  a  syphon-bend  close  under  the  basin,  to 
prevent  offensive  smells  from  decomposing  soap  in  the  waste 
pipe,  and  a  ventilating  pipe  from  this  to  prevent  the  water  in 
the  bend  being  exhausted  by  syphon-action.  (Fig.  12.)  The 
preceding  plan  is  the  best  where  there  is  not  frequent  danger 
of  the  water  freezing  in  the  gully-trap.  (£,  Fig.  12.)  In  the 
States,  however,  this  is  so  common  an  event  in  winter  that  the 


DRAINAGE  ARRANGEMENTS. 


47 


gully-trap  has  to  be  abandoned ;  and  the  lavatory  waste-pipe 
must  be  directly  connected  with  other  waste-pipes  which  dis- 
charge into  the  drain.  In  this  case  the  syphon-bend  shown  at 
ft  and  the  ventilation  shaft  shown  at  dt  must  be  insisted  on. 
(Fig.  12.) 


I  I 

FIG  12.— Lavatory  wash-basin. 

a,  Waste-pipe,  emptying  over  water-seal  of  gully-trap  (b) ;  e,  syphon-trap  in 
waste-pipe  to  prevent  foul-air  from  waste  pipe  getting  into  room  ;  d,  ventila- 
ting pipe  from  syphon  to  prevent  unsyphoning ;  e,  discharge  of  overflow  pipe. 

Urinals  are  best  furnished  with  china  or  glazed  earthen- 
ware pans,  as  these  hardly  allow  any  sediment.  Slate,  stone,  or 
cement  slabs  should  not  be  used,  as  the  rougher  surface  allows 
deposit,  and  they  can  be  written  on.  Water  should  not  be 
allowed  to  trickle  down  for  cleansing  purposes,  as  children 
play  with  it,  and  even  try  to  drink.  Frequent  washing  by  an 
attendant  is  best,  or  the  provision  of  an  automatic  flush-tank, 
which  discharges  its  contents  at  intervals.  Five  places  fox 


40  SCHOOL    HYGIENE. 

each  hundred  children  are  required.  The  waste-pipe  from  the 
urinal  should  open  into  a  ventilated  trap,  and  not  be  directly 
connected  with  the  drain. 

Closets  should  never  be  placed  in  the  basement  under  the 
school.  They  may  be  partially  connected  with  the  school  by 
a  covered  subway,  but  should  always  be  in  a  separate  building. 
The  walls  of  the  closet  should  be  of  a  material  that  cannot  be 
written  on,  tiles  being  best  for  this  purpose,  and  all  closets 
should  be  frequently  inspected.  The  proper  allowance  is  one 
seat  for  every  15  girls  or  25  boys  (or  less),  the  seats  being 
proportionate  to  the  children's  stature,  and  the  closets  divided 
by  partitions.  There  should  be  separate  provision  for  teachers 
and  the  two  sexes. 


FIG,  13.— Pan  closet,  with  D  trap  beneath. 

An  illustration  of  the  form  of  closet  most  commonly  used,  but  most  dangerous 

to  health. 


JJKAINAGE    ARRANGEMENTS. 


The  common  privy  is  most  objectionable  from  a  sanitary 

standpoint.     Either  water  or  earth  closets  should  be  employed. 

Of  water-closets,    pan-closets  are  always  bad,  and  simple 


FIG.  14. — An  improved  hopper  closet. 

valveless  closets  are  most  suitable.  The  water  supply  should 
be  abundant,  and  from  a  cistern  distinct  from  that  supplying 
drinking-water.  The  amount  of  fall  from  the  cistern  to  the 
closet  should  be  at  least  3  or  4  feet,  and  the  internal  diameter 
of  the  flushing-pipe  at  least  ij  inch.  For  teachers'  closets, 
the  valve  closet  shown  in  Fig.  1 5  is  a  very  good  form,  especially 
where  such  a  closet  is  in  the  main  building  near  class-rooms. 
As  lifting  a  handle  is  reonired  for  flushing  purposes,  it  should 
never  be  allowed  for  children,  for  whom  the  valveless  closet 
shown  in  Fig.  14  is  most  suitaol  t  combined  with  an  automatic 
flushing  arrangement,  worked  by  rising  from  the  seat. 

Instead  of  isolated  water-closets,  the  tumbler-closet  or  trough- 
closet  may  be  employed,  each  having  a  number  of  seats  and  a 
water-tight  trough  below,  the  contents  of  which  are  emptied 
only  at  intervals  by  a  flush  of  water,  and  the  removal  of  a 


5° 


SCHOOL   HYGIENE. 


plug.  It  carefully  superintended,  such  an  arrangement  works 
fairly  well ;  but  if  neglected,  a  considerable  nuisance  is  pro- 
duced. 

The   soil-pipe   should    be   carried    above   the   roof  of    the 


FIG.  15.  —  A  sanitary  valve-closet. 

a,  valve  which  is  opened  by  a  handle;  6,  overflow  pipe  from  pan  of  closet; 
c,  small  ventilating-pipe  connected  with  syphon-trap  to  prevent  its  being 
emptied  of  water  by  syphon-action  (it  is  carried  through  the  wall  a  little 
higher  up) ;  d,  waste-pipe  from  tray  to  catch  accidental  shillings,  made 
to  discharge  beyond  the  outer  wall,  and  not  connected  with  soil-pipe; 
e,  ventilating-shaft  continued  upward  from  soil-pipe. 

school-building,  with  a  wire  grating  over  the  top,  and  a  ven- 
tilated  trap   placed   at   the  other  end   of  the  school   drain- 


DRAINAGE   ARRANGEMENTS.  51 

age  system,  thus  insuring  complete  ventilation  of  the  school- 
drain. 

The  Drain-pipe  should  be  as  small  as  is  consistent  with  its 
carrying  away  all  waste  matters.  The  larger  it  is,  the  more 
liable  it  is  to  become  blocked.  Iron  pipes  are  preferable  to 
brick  or  earthenware,  especially  within  the  house.  They 
should  be  coated  inside  and  out  with  some  material  which 
completely  withstands  all  chemical  action  and  changes  of 
temperature. 

The  drain-pipe  should  be  separated  from  the  main  sewer  by 
a  syphon-trap  which  is  ventilated,  thus  allowing  fresh  air  to 
sweep  from  one  end  of  the  school  drainage  system  to  the  other. 


FIG.  16. — Vertical  section  of  disconnecting-chamber  with  Intercepting  trap, 
showing  ventilation  of  school-drain  and  method  of  reaching  pipes  for 
cleansing  purposes. 


SCHOOL   HYGIENE. 


Under  no  circumstances  should   a   cesspool^   "the  king  of 
nuisances,"  be  allowed   to  receive  the    school-drainage.      It 


2  3 

FIG.  17. — Iron  cover  to  disconnecting-chamber. 

I,  The  iron  cover  removed.    2,  Section  of  cover  and  frame.     3,  India-rubber 
seating  at  angle,  forming  an  air-tight  junction. 

forms  a  manufactory  for  poisonous  sewer-gases,  even  more 
effectually  than  a  badly-constructed  sewer.  The  soil  around 
the  cesspool  tends  to  become  "  excrement-sodden,"  and  the 
water  of  any  well  in  the  neighbourhood  is  in  constant  danger 
of  contamination. 

Children  are  apt  to  play  or  hide  about  retired  parts  of  the 
school-ground,  and  thus  may  be  endangered  by  the  effluvia 
from  the  cesspool. 

When  there  is  no  central  system  of  drainage,  Earth-closets 
should  always  be  used,  and,  even  when  this  is  available,  earth- 
closets  present  a  great  advantage  in  the  absence  of  fear  of 
the  water-supply  becoming  frozen.  It  is  found  that  ijlb.  of 
dry,  loamy  earth  will  completely  deodorise  the  closet  each 
time  it  is  used.  The  earth  must  be  dry.  It  has  been  well 
said  by  Moule,  the  originator  of  the  system,  that  "  an  earth 
closet  will  no  more  work  without  dry  earth,  than  a  water-closet 


DRAINAGE   ARRANGEMENTS.  53 

will  work  without  water."     Pure  sand  and  gravel  or  chalk  are 
nearly  useless,  but  sawdust  answers  fairly  well. 

When  earth-closets  are  adopted,  the  waste  water  from 
lavatories  and  urinals  requires  separate  treatment.  In  country 
places  the  best  plan  is  to  collect  the  waste  water  in  an  automatic 
flush-tank,  which,  when  it  becomes  full,  discharges  all  its 
contents  into  loosely-laid  drains  under  the  surface  of  a  garden 
or  field.  In  this  way  the  water  is  effectually  discharged  at 
intervals,  while  at  the  same  time  a  sodden  condition  of  the 
soil  is  not  produced. 


PART    II. 

SCHOLARS. 


CHAPTER   IX. 
MENTAL  EXERCISE. 

Full  Scope  of  Education. — Quantity  and  Quality  of  Brain.— The 
Brain  a  Compound  Organ.— Functional  Habits  of  Brain.— Blood 
Supply. — Sensory  and  Muscular  Education  of  Brain. 

IT  cannot  be  too  clearly  understood  that  the  function  of 
education  is  to  prepare  a  child  for  his  after-life,  and  the  true 
test  of  the  value  of  an  educational  course  lies  in  whether  it 
fulfils  this  end.  In  order  that  the  preparation  may  be  complete, 
the  physical,  mental,  and  moral  parts  of  a  child's  nature  must 
be  embraced  within  its  scope.  A  lack  of  education  in  any  one 
of  these,  leads  to  the  production  of  an  ill-balanced  and  defective 
manhood.  These  parts  of  our  nature  are  inextricably  associ- 
ated, and  defects  in  one  react  injuriously  on  the  others.  It  is 
unfortunate  that  so  very  narrow  a  view  of  the  scope  of  education 
is  usually  taken.  That  is  the  best  schooling  which  most 
completely  prepares  a  child  for  his  future  career,  by  training 
his  powers  of  observation,  memory,  and  reflection,  while  at  the 
same  time  imparting  knowledge  which  shall  be  of  practical 
service  in  life. 

Physical  education  we  shall  discuss  in  Chap.  XII.;  here  wo 
are  chiefly  concerned  with  mental  education  in  its  bearings  on 
health. 

Whatever  view  of  the  relation  of  mind  and  brain  be  taken 
57 


5  SCHOOL    HYGIENE. 

it  will  be  agreed  that  the  brain  is  the  instrument  necessary  to 
all  mental  operations. 

The  exercise  of  the  brain  involved  in  education  leads  to  an 
increase  in  its  size  and  an  improvement  in  its  quality  beyond 
what  occurs  in  the  uneducated.  The  average  weight  of  the 
brain  in  the  adult  European  is  between  49  and  50  ounces.  In 
civilised  races  it  is  heavier  than  in  the  less  civilised,  and  even 
in  the  highly-civilised  races  an  increase  in  the  size  of  the  brain 
has  occurred  in  historic  times. 

At  birth  the  weight  of  the  brain  averages  from  n  to  14 
ounces,  and  a  progressive  increase,  most  rapid  in  the  earlier 
years,  occurs,  the  greatest  average  weight  of  the  male  brain 
being  reached  at  the  age  of  35,  and  of  the  female  brain  at 
about  30. 

Just  as  increased  muscular  exercise  leads  to  increased  size 
and  strength  of  the  muscles,  so  may  increased  brain-exercise, 
during  the  period  of  its  natural  growth,  accelerate  and  increase 
the  individual  growth  of  brain,  and  lead  to  the  transmission  of 
a  tendency  to  larger  brains. 

Size  of  brain  is  not  the  only  consideration,  for  the  brain  of  a 
child  seven  years  old  is  equal  to  nine-tenths  of  its  weight  in 
the  adult,  and  at  three  years  it  is  equal  to  three-fourths  of  the 
full  weight.  Nevertheless,  other  things  being  equal,  the  man 
with  the  largest  brain  has  the  greatest  chance  of  success. 

The  quality  of  the  structure  of  a  brain,  and  the  degree  of 
elaboration  of  its  grey  matter,  have  also  to  be  considered  ;  and 
they  vary  much,  even  in  brains  of  equal  size.  Education 
doubtless  elaborates  the  structure  of  a  brain,  and  multiplies 
connections  between  its  cells,  as  well  as  probably  increasing  the 
number  of  cells. 

The  brain  must  hardly  be  considered  as  a  single  organ,  but 
a  collection  of  organs,  which,  although  most  intimately  united, 
are  also  capable  in  some  degree  of  independent  action, 


MENTAL   EXERCISE.  59 

Different  con vo'u  ions  of  the  brain  have  been  proved  by 
Hitzig  and  Ferrier  to  have  special  functions,  and  it  is  probable 
that  excessive  development  of  any  one  faculty  is  accompanied 
by  a  disproportionate  development  of  a  corresponding  con- 
volution. The  importance  of  early  and  systematic  exercise 
directed  to  the  uniform  development  of  all  parts  of  the  brain, 
cannot  be  exaggerated.  A  genius  in  one  direction  should  not 
be  allowed  too  early  to  follow  its  own  bent,  or  an  ill-balanced 
mind  is  the  inevitable  consequence  There  is  some  degree  of 
truth  in  the  statement  that  there  is  but  a  step  between  the  ill- 
balanced  brain  of  a  genius  and  that  of  a  lunatic. 

Studies  requiring  observation,  memory,  or  reasoning-power, 
bring  into  action  different  parts  of  the  brain,  and  should  all  in 
turn  receive  careful  and  balanced  attention.  If  the  emotions 
are  allowed  to  have  a  preponderant  influence,  life  becomes 
wavering  and  uncontrolled  by  the  will ;  while  in  some  logically- 
minded  individuals  the  emotions  seem  to  have  no  place. 

The  u  ility  ot  a  brain  depends  largely  on  \\s>  functional  habits. 
Corresponding  to  each  thought,  there  is  probably  a  nerve- 
current  in  a  particular  part  of  the  brain.  Currents  of  nerve- 
force  travel  preferably  in  the  pathways  of  least  resistance,  and 
these  are  where  currents  have  repeatedly  passed.  Careful  and 
persevering  attention  to  special  points  will  thus  strengthen 
individual  character,  and  may  even  lead  to  the  formation  of 
new  mental  habits.  In  this  way  it  may  be  possible  to 
counteract  evil  hereditary  tendencies,  and,  by  the  aid  of  a  wise 
teacher,  to  form  a  strong  and  evenly-balanced  mind. 
„.  The  brain  is  dependent  for  the  continuance  of  its  functions 
on  an  abundant  and  pure  sufipiy  of  blood.  Any  mental  excite- 
ment causes  a  determination  of  blood  to  the  brain.  The  more 
the  brain  is  exercised  within  reasonable  limits,  the  more 
blood  it  receives,  and  consequently  the  more  it  grows.  If  one 
part  of  the  brain  is  disproportionately  exercised,  it  grows  dis- 


60  SCHOOL    HYGIENE. 

proportionately,  while  if  the  exercise  is  excessive  other  evils 
may  be  produced.  (See  Chap.  X.) 

Deficient  food,  indigestion,  or  an  impure  atmosphere,  causes 
listlessness,  apathy,  headache,  and  other  nervous  symptoms, 
owing  to  impoverishment  of  the  brain  by  deficient  blood,  or 
poisoning  of  it  by  impure  blood. 

The  brain  is  not  only  the  organ  of  thought  and  volition  and 
the  emotions,  but  is  also  the  centre  for  the  reception  of 
impressions  from  other  parts  of  the  body  and  the  external 
world,  and  the  interpretation  of  these. 

The  influence  of  sensory  and  muscular  impressions  on  the 
brain  is  so  important  as  to  call  for  some  further  remarks. 

Sensations  are  perceived  as  such  in  the  brain,  the  sensory 
organ  (eye,  ear,  etc.)  simply  serving  as  a  receptive  medium 
which  conveys  the  external  stimulus  to  the  brain. 

The  different  sensations  are  received  in  separate  parts  of 
the  brain.  The  resultant  of  these  sensations  stored  up  in  the 
brain  constitutes  memory.  It  is  evident  that  the  cultivation 
of  one  sensory  organ  (or  rather  of  the  corresponding  part  of 
the  brain)  may  be  encouraged  to  the  neglect  of  other  senses, 
and  thus  an  ill-balanced  condition  produced.  For  instance,  a 
boy  may  have  an  excellent  sense  of  touch,  or  an  accurate 
perception  of  weight  and  resistance,  and  yet  have  no  taste  for 
music.  Each  sense  requires  special  cultivation,  and  becomes 
skilled  in  proportion  to  the  education  received.  It  has  been 
well  said  by  Dr.  Clarke  :  "  If  a  single  organ  is  wanting,  or  a  single 
function  not  performed,  just  so  much  less  brain  development 
results."  It  is  also  unhappily  true  that  the  imperfect  per- 
formance of  any  one  mental  function  reacts  injuriously  on 
others.  Hence  the  truth  of  the  poetical  statement — 

"  Break  but  one 

Of  a  thousand  keys,  and  the  paining  jai 
Through  all  will  run."— (Whittier.) 


MENTAL   EXERCISE.  6l 

When  the  education  of  the  senses  is  neglected,  all  subsequent 
education  has  a  haziness  about  it  which  is  almost  irremediable. 
The  Kindergarten  system,  cultivating  the  senses  and  powers 
of  observation  and  construction  from  the  earliest  period,  is  of 
great  value  in  this  connection. 

The  brain  controls  and  commands  all  voluntary  muscular 
movements.  In  doing  this,  the  motor  part  of  the  brain  is 
necessarily  exercised.  In  this  way,  gymnastics  exercise  the 
brain  and  increase  its  size.  If  an  arm  is  amputated  or 
paralysed  in  infancy,  there  is  so  much  less  brain  in  the  adult. 
The  influence  of  muscular  exercise  on  brain-development  will 
be  further  discussed  in  Chap.  XII. 

Brain-exercise  is  not  carried  on  solely  in  our  schools.  It 
commences  at  the  earliest  period  of  life,  and  never  ceases 
throughout  conscious  existence. 

In  .the  early  years  of  life,  the  sensory,  motc~;  and  observing 
portions  of  the  brain  a^e  chiefly  exercised ;  while  the  exercise 
of  the  reasoning-powers  and  memory  is  that  with  which 
teachers  are  chiefly  concerned.  We  must  again  repeat,  how- 
ever, that  any  education  which  does  not  bring  into  healthful 
and  balanced  action  every  part  of  a  child's  nature  cannot  be 
regarded  as  satisfactory  or  complete. 


CHAPTER  X. 

EXCESSIVE  MENTAL  EXERCISE. 

Symptoms  and  Effects  of  Brain- forcing. —The  "  Cram"  System.—' 
Causes  of  Over-strain  — Home  Lessons. — Badly-arranged  Wotk. — 
Importance  of  Technical  Instruction. — Good  and  Bad  Examina- 
tions. — Consumption  from  Over-  work.  — Punish  ments. 

THE  general  raising  of  the  standard  of  education  and  the  fact 
that  it  is  becoming  universal,  render  the  danger  of  excessive 
mental  exercise  increasingly  great. 

An  adult  brain  in  the  intervals  of  work  has  to  repair  its 
structural  losses  and  lay  up  a  store  of  potential  energy  for  future 
use  ;  the  brain  during  the  period  of  school-life  has  also  to 
build  up  fresh  material  for  its  growth. 

If  we  obtain  mental  maturity  at  an  early  age,  it  is  at  the  ex- 
pense of  stability  and  real  power.  The  higher  the  organism 
the  longer  it  takes  to  arrive  at  maturity,  is  a  biological  law 
the  truth  of  which  is  shown  by  the  fact  that  precocity  is 
generally  followed  by  inferior  mental  organisation.  Striking 
exceptions  to  this  rule  will  doubtless  occur  to  the  reader,  but 
the  truth  of  it  in  ordinary  cases  is  fairly  established. 

The  evils  of  a  vicious  system  of  education  were  long  ago 

depicted  by  Charles  Dickens.     "  Dr.  Blimber's   establishment 

was  a  great  hot-house  in  which  there  was  a  forcing-apparatus 

constantly  at   work.       Mental   green-peas  were  produced  at 

62 


EXCESSIVE   MENTAL    1  X"RCISE.  63 

Christmas,  and  intellectual  asparagus  all  the  year  round. 
Nature  was  of  no  consequence  at  all ;  no  matter  what  a  young 
gentleman  was  intended  to  bear,  Dr.  Blimber  made  him  bear  to 
order  somehow  or  other.  This  was  very  pleasant  and  inge- 
nious, but  the  system  of  forcing  was  attended  with  its  usual 
disadvantages  ;  there  was  not  a  right  taste  about  the  premature 
productions,  and  they  didn't  keep  well.  .  .  .  And  people 
did  say  that  the  Doctor  had  rather  overdone  it  with  young 
Toots,  who,  when  he  had  whiskers,  left  off  having  brains." 

Ordinary  school-work,  interrupted  by  vacations,  seldom 
produces  excessive  strain  on  the  mental  powers  of  children.  It 
is  only  in  exceptional  cases,  where  the  children  are  insufficiently 
fed,  or  are  of  a  peculiarly  excitable  temperament,  or  where 
the  hours  of  study  are  unduly  prolonged,  that  this  result  is  likely 
to  ensue.  Such  over-strain  may  also  occur  when  one  particular 
class  of  work  is  persisted  in  to  excess,  to  the  exclusion  of  varied 
work  and  of  recreative  exercise. 

In  such  cases,  headache  is  one  of  the  first  symptoms  to  attract 
attention.  The  parent  is  a  much  better  judge  as  to  whether 
the  school-work  is  overtaxing  the  child,  than  the  teacher,  as 
the  latter  has  to  deal  with  a  large  class  and  can  scarcely  watch 
with  sufficient  care  each  child.  If  a  child  frequently  complains 
of  headache,  it  may  be  due  to  overwork,  though  the  far  more 
frequent  causes — such  as  indigestion,  bad  atmosphere,  defects 
of  vision — should  first  be  eliminated. 

Many  children  seem  indolent  and  stupid  in  school.  The 
proper  remedy  for  this,  in  not  a  few  cases,  is  not  some  form  of 
punishment,  but  attention  to  the  general  state  of  health,  or 
sometimes  a  relaxation  of  studies.  In  some  cases,  apparent 
stupidity  is  really  due  to  some  defect  of  vision,  a  form  of  "arti- 
ficial stupidity  "  which  is  discussed  in  Chap.  XVII. 

The  brain  may,  in  rare  cases,  become  congested  from  over- 
work, and  in  certain  cases,  where  a  strong  tubercular  tendency 


64  'SCHOOL    HYGIENE. 

exists,  this  would  tend  to  produce  meningitis  (brain-fever).  It 
would  be  unfair,  however,  to  ascribe  tubercular  meningitis 
directly  to  school-work,  as  it  is  common  both  before  and  after 
the  school-period  of  life.  The  school-work  (like  any  other 
form  of  excitement)  might  tend  to  hasten  such  an  attack. 

Dr.  Sturges,  in  the  Lancet  (Jan.  3,  1885),  gives  200  cases  of 
chorea  (St.  Vitus's  dance),of  which  79  were  of  known  causation, 
and  14  of  these,  or  i  in  6,  were  apparently  due  to  schooling. 
Doubtless  the  14  should  be  taken  from  a  larger  number  than 
79,  and  tliQ  fact  that  chorea  in  children  who  do  not  attend 
school,  occurs  chiefly  in  the  school-period  of  life,  must  be 
remembered. 

Dr.  Me  Lane  Hamilton's  recent  investigations  show  that  over 
20  per  cent,  of  the  young  children  in  the  public  schools  of 
New  York  have  choreic  affections  of  greater  or  less  gravity. 

Chorea  is  a  disease  rather  of  the  poor  than  of  the  rich,  so 
under-feeding  may  be  a  factor  in  its  production.  Very  often 
a  sudden  shock,  as  from  a  severe  whipping  or  a  fright,  is  the 
cause,  though  this  would  be  much  more  likely  to  produce  the 
disease  if  the  child's  brain  were  in  an  overstrained  condition. 

The  tendency  for  parents  to  send  their  children  to  school  as 
soon  as  they  have  recovered  from  acute  illnesses,  is  greatly  to  be 
deprecated.*  After  fevers,  for  instance,  it  takes  some  months 
before  the  brain  recovers  its  former  condition  of  nutrition  and 
power.  After  severe  blows  on  the  head,  or  concussion  of  the 
brain,  again,  children  should  be  allowed  prolonged  mental  rest, 
or  a  tendency  to  epilepsy  or  other  diseases  may  be  developed. 

Excessive  study  is  a  mistake,  from  every  point  of  view.  It 
defeats  its  own  ends ;  the  mind  cannot  assimilate  beyond  a 
certain  rate,  any  more  than  can  the  digestive  organs ;  and  it 

*  The  insistance  by  School- Board  officers  of  an  early  return  to 
school  of  children  who  have  been  seriously  ill,  is  a  real  evil,  which 
falls  heavily  on  the  poor. 


EXCESSIVE   MENTAL   EXERCISE.  65 

makes  study  distasteml  to  children,  and  consequently 
encourages  the  shirking  of  tasks. 

It  is  a  mistake  also,  because  it  assumes  that  the  acquisition 
of  knowledge  is  everything,  forgetting  that  the  organisation  of 
knowledge,  for  which  time  and  thought  are  required,  is  the 
essentially  important  matter.  "  It  is  not  the  knowledge  stored 
up  as  intellectual  fat  which  is  of  value,  but  that  which  is  turned 
into  intellectual  muscle."  (Herbert  Spencer.) 

The  folly  of  what  is  known  as  the  "  cram  "  system  becomes 
evident  in  this  connection.  The  knowledge  imparted  in  sucli  a 
way  is  speedily  lost,  while  at  the  same  time  the  1  rain  is  unfitted 
for  healthful  and  spontaneous  exercise  in  the  future. 

It  is  a  mistake  also,  because,  in  the  young,  it  interferes  with 
the  due  development  of  the  whole  body.  The  increased 
circulation  of  blood  in  the  brain  implies  diminished  circulation 
through  the  limbs  and  other  parts  of  the  system.  Even 
supposing  that  increased  mental  power  is  the  result,  the  general 
physique  necessary  to  make  it  available  in  the  battle  of  life,  is 
wanting  ;  unless  a  man  is  "  a  good  animal,"  one  of  the  first 
requisites  for  success  in  life  is  absent.  But  increased  mental 
power  is  not  the  result.  The  abnormally -rapid  advance  of  any 
organ  in  respect  of  structure,  involves  premature  arrest  of  its 
growth.  A  forced  brain  usually  falls  short,  in  the  end,  of  the 
normal  standard  of  size  and  power. 

Many  causes  may,  in  badly-arranged  schools,  lead  to  the 
production  of  over-strain  in  children. 

They  may  be  classified  as  influences  operating  through  the 
general  health,  home-lessons,  bad  arrangement  of  work,  ex- 
aminations, and  punishments. 

(i.)  Very  often  the  amount  of  work  is  not  in  itself  exces- 
sive, but  the  scholar's  health  is  depreciated  by  deficient  ex- 
ercise, impure  air,  deficient  clothing,  or  insufficient  or  unsuit- 
able food.  These  matters  will  be  discussed  in  later  chapters. 
v 


66  SCHOOL   HYGIENE. 

(2.)  Not  uncommonly  the  school-lessons  are  not  excessive, 
but  home-lessons  are  given  which  require  prolonged  attention, 
and  leave  too  little  time  for  meals  or  recreation.  Parents  can 
best  judge  as  to  whether  home-lessons  are  doing  harm,  and 
and  should  at  once  communicate  with  the  teacher,  if  any  in- 
dications of  over-pressure  appear.  In  any  case,  home-lessons 
should  be  reduced  to  a  minimum,  should  not  require  to  be 
done  in  the  evening,  and  should  rather  take  the  form  of  re- 
capitulation of  work  done  during  the  day  than  break  into  new 
ground. 

(3.)  The  School-work  may  be  badly  arranged. — The  most 
common  fault  under  this  head  is  too  long  lessons.  The  brain 
becomes  fatigued  when  attention  to  one  subject  is  prolonged. 
Much  better  results  can  be  obtained  in  an^  hour's  lesson  by 
devoting  five  minutes  in  the  middle  of  it  to  drill-exercises,  than 
if  the  whole  hour  is  devoted  to  mental  work.  Lessons  should 
never  exceed  an  hour  in  duration  even  for  elder  scholars,  and 
three-quarters  of  an  hour  is  preferable.  Singing  or  drill- 
exercises  for  a  few  minutes  in  the  interval  arouse  the  nervous 
energies  and  facilitate  subsequent  attention  to  work. 

Even  during  school-hours  much-  can  be  done  to  diminish 
fatigue  by  change  oj  subjects.  Thus  languages  or  history  should 
alternate  with  mathematics,  memory  and  reasoning  being 
successively  exercised.  Then  mechanical  work,  as  writing  or 
drawing,  may  follow,  succeeded  by  object-lessens  and  experi- 
mental lectures.  By  some  such  succession  as  this  the  best 
results  can  be  obtained  with  the  least  mental  fatigue.  In  this 
connection,  the  proposed  introduction  of  technical  and  indus- 
trial instruction  into  elementary  schools  is  a  most  important 
step  in  the  right  direction,  and  will  have  invaluable  influence 
on  both  the  mental  and  physical  training  of  children.  The 
time  devoted  to  manual  instruction,  while  it  is  useful  in  itself 
as  an  introduction  to  industrial  occupations,  has  an  important 


EXCESSIVE   MENTAL   EXERCISE.  67 

bearing,  which  has  already  been  discussed,  on  the  due  develop- 
ment of  every  part  of  the  brain,  and  on  the  maintenance  of 
that  balance  between  different  parts,  upon  which  healthful  and 
co-ordinated  mental  action  depends. 

(4)  Examinations  are  chiefly  sources  of  danger  to  older 
scholars,  especially  when  they  are  of  a  competitive  character, 
bringing  into  action  the  force  of  emulation.  The  mobile 
nervous  system,  and  the  somewhat  greater  preponderance  of 
the  emotional  faculties  in  girls,  render  them  peculiarly  prone 
to  suffer  when  subjected  to  competitive  examinations. 

We  are  not  prepared  to  condemn  examinations ;  it  would  be 
difficult  or  even  impossible  to  discover  an  efficient  substitute. 
If  well  conducted,  an  examination  may  be  of  great  educative 
value.  It  finds  out  weak  points,  and  shows  how  future  efforts 
may  be  made  more  successful,  while  the  anticipation  of  the 
examination  guides  and  stimulates  the  scholar's  efforts.  The 
best  results  of  a  teacher's  work,  especially  his  personal  influence 
on  the  training  of  mental  or  moral  faculties,  and  the  influence 
of  an  upright  and  consistent  example,  can,  however,  never  be 
brought  to  the  test  of  an  examination. 

Doubtless  the  best  motive  for  studying  a  subject  would  be 
the  interest  it  affords ;  but  this  cannot  be  aroused  till  the 
scholar  enters  the  subject,  and  sometimes  not  even  then  ;  hence 
the  necessity  for  some  external  definite  motive. 

Examinations  at  the  best  are  but  means  to  an  end ;  they 
cease  to  be  beneficial  when  they  are  made  the  object  of  the 
teacher's  tuition,  and  they  are  most  pernicious  when  undue 
strain  is  put  on  children  for  some  weeks  before  the  known  date 
of  an  examination  rather  than  a  steady  unwavering  system  of 
work  throughout  the  year.  Examinations,  in  order  to  be 
satisfactory,  should  review  the  work  actually  done  by  the 
scholar.  The  duty  of  the  examiner  is  rather  to  find  out  how 
much  the  scholar  knows,  than  to  distress  him  by  revealing  his 

F   2 


68  SCHOOL    HYGIENE. 

ignorance  on  obscure  points.  An  examination  of  the  former 
kind  may  be  a  healthful  and  encouraging  stimulus,  while  one 
of  the  latter  kind  leaves  only  a  sense  of  embarrassment 
and  irritation  in  the  scholar's  mind,  which  weakens  him  for 
future  efforts. 

The  occurrence  of  headaches,  restlessness,  irritability,  and 
inability  to  fix  the  attention,  are  finger-posts  showing  over-work 
in  preparation  for  examinations,  and  should  receive  early  at- 
tention. 

In  1872  the  Massachusetts  Board  of  Health  enquired  by 
circular  of  a  number  of  physicians  and  teachers  whether  in  their 
experience  phthisis  (consumption)  was  ever  brought  on  by 
over-study.  Of  191  replies,  146  were  in  the  affirmative,  and 
Dr.  Bowditch,  then  Chairman  of  the  Board,  said:  "I  find 
almost  invariably  in  patients  predisposed  to  phthisis,  that  a 
prize  gained  or  an  examination  concluded  is  the  signal  for 
entire  decay  of  the  physical  powers,  under  the  violent  strain 
put  previously  on  the  mind,  and  with  a  total  neglect  of  corre- 
sponding physical  exercise."  The  fact  that  such  a  large 
proportion  of  answers  were  in  the  affirmative  is  not  so 
conclusive  as  at  first  sight  appears ;  for  those  doctors  having 
definite  cases  to  narrate  would  be  much  more  likely  to  answer 
the  circular  than  others  whose  experience  was  negative. 

(5.)  Punhhments  are  a  valuable  means  of  bringing  refrac- 
tory children  to  reason ;  though  the  fear  of  them,  when  wielded 
by  an  unmerciful  teacher,  may  lead  nervous  children  to 
excessive  and  injurious  efforts. 

The  advisability  of  corporal  punishment  is  a  somewhat 
vexed  question.  It  is  urged  against  it  that  it  is  hurtful  and 
degrading  to  those  who  receive  it,  while  it  hardens  the 
sensibilities  of  those  who  inflict  it.  The  latter  is  certainly  not 
true,  if  the  punishment  is  moderate,  and  not  inflicted 
under  the  influence  of  passion.  As  regards  the  former,  most 


EXCESSIVE   MENTAL   EXERCISE.  69 

teachers  assert  that  there  are  children  so  wayward  and 
obstinate,  that  there  is  no  way  of  controlling  them  except 
through  fear  of  bodily  pain.  If  bodily  punishment  is  ever 
inflicted,  it  should  be  as  a  last  resort,  and  at  an  hour-or-two's 
interval  after  the  offence  requiring  it,  in  order  that  the  punish- 
ment may  not  be  vindictive,  and  that  it  may  be  quite  clear  to 
the  delinquent  that  the  teacher  is  simply  the  instrument  of 
punishment  which  is  the  natural  result  of  the  offence. 

Certain  forms  of  corporal  punishment  should  never  be 
allowed.  Boxing  the  ears  or  blows  on  the  head  are  always 
dangerous,  and  so  is  the  use  of  a  hard  inflexible  stick. 

It  would  appear  that  teachers  are  gradually  finding  that  they 
can  maintain  discipline  without  any  form  of  corporal  punish- 
ment. In  the  city  of  New  York  it  has  been  forbidden  in  the 
public  schools,  expulsion  being  substituted  for  it  as  a  demur 
ressort. 

The  giving  of  impositions  requiring  the  keeping-in  of  the 
scholar  for  a  prolonged  period,  and  interfering  with  his  meals 
and  recreation,  should  seldom  be  had  recourse  to.  The  plan 
of  having  good  and  bad  marks,  which  are  subsequently  reported 
to  parents  and  made  the  subject  of  rewards,  works  much 
better  than  any  form  of  corporal  punishment. 


CHAPTER  XI. 
AGE  AND  SEX  IN  RELATION  TO  SCHOOL-WORK. 

Duration  of  School-work  at  various  Ages.— Statistics  of  Children 
attending  School  at  various  Ages. — Growth  and  Development  in 
relation  to  School  work.—  Weight  and  Size  of  Children.—  Chart  oj 
Growth  of  Children— Sex  in  Education.— Character  of  Educa- 
tion in  relation  to  Sex. 

AGE  has  a  most  important  bearing  on  the  character,  amount, 
and  distribution  of  the  work  to  be  given  to  children.  During 
the  period  of  childhood,  including  up  to  the  end  of  the  yth 
year,  more  rapid  changes  are  being  undergone  than  at  any 
subsequent  period  of  life.  At  7  years  old  a  child  weighs  about 
6  times  as  much  as  at  birth,  and  has  half  the  stature,  and  from 
one-third  to  one-fourth  of  the  weight  of  an  adult.  The  less 
book-work  the  better,  during  this  period.  Education  is 
not  confined  to  schools.  From  the  first  moment  of  life  edu- 
cation in  the  best  sense  commences,  and  makes  rapid  strides. 
The  senses  become  trained,  and  the  powers  of  observation  are 
perhaps  keener  than  at  any  subsequent  period,  while  the  mind 
is  becoming  stored  with  impressions  which  form  the  ground- 
work of  subsequent  mental  life. 

Much   depends   on   the  general  training  of  a  child  during 
this   period.     His   habits   are   being  formed,  and    his   after- 
70 


AGE  AND   SEX   IN    RELATION   TO   SCHOOL-WORK. 


progress  in  life  is  largely  determined  by  the  parental  and  other 
influences  to  which  he  is  at  this  time  subjected. 

Various  opinions  are  held  as  to  the  age  at  which  attendance 
at  school  should  begin.  The  following  table  gives  the  per- 
centage at  different  ages,  for  the  4,412,148  children  attending 
public  elementary  schools  in  England  and  Wales  during  the 
year  1885.  (Report  of  Committee  of  Council  on  Education, 
1885-6,  p.  210.) 


Age. 

Per  cent. 

Age. 

Per  cent. 

Under  3  years. 

•20 

8-9 

11-95 

3-4 

289 

9—10 

1174 

4-5 

6-58 

10—  II 

11-45 

5-6 

10*00 

II—  12 

lO'II 

6-7 

11-40 

12-13 

7*1 

7-8 

1177 

I3-M 

3'2i 

14  and  over 

•89 

It  will  be  seen  from  this  table  that  10  per  cent,  of  the  total 
number  of  scholars  attending  school  are  under  5  years  of  age, 
and  that  31  per  cent,  are  under  7  years  of  age.  This 
strikingly  shows  that  there  is  a  marked  tendency  to  crowd  the 
work  of  school-education  into  the  very  early  years  of  life,  and 
it  is  therefore  of  the  greater  importance  to  consider  what 
should  be  the  nature  of  this  education  from  a  hygienic  stand- 
point, in  order  that  the  danger  which  such  early  attendance 
implies,  may  be  averted. 

What  education  then  may  safely  be  given  at  such  an  age  ? 
We  have  already  pointed  out  that  in  the  early  years  of  life  the 
powers  of  observation  are  alone  among  the  mental  functions 


7»  SCHOOL   HYGIENE. 

which  are  in  active  operation.  To  these,  then,  the  instruction 
must  be  primarily  addressed.  If  the  mental  activities  of 
subsequent  years  are  anticipated,  and  the  reflective  powers 
are  prematurely  stimulated,  the  result  cannot  be  otherwise  than 
disastrous  to  the  mental  and  physical  health  of  the  child. 

Undoubtedly  the  zeal  of  elementary  school  teachers  has 
tended  in  the  latter  direction,  and  it  is  interesting  to  note  that 
in  the  later  forms  of  school  laws,  a  sounder  and  more  physio- 
logical method  is  being  approached.  The  "merit  grant" 
in  infant-schools  can  now  be  obtained  only  on  condition 
that  simple  lessons  on  objects,  and  on  the  phenomena  of 
nature,  and  of  common  life  (which  appeal  primarily  to  the 
senses  and  the  powers  of  observation)  are  given,  attended  by 
appropriate  and  varied  occupations.  This  is  a  valuable  step 
in  the  right  direction,  and  will  require  further  extension,  if 
future  generations  are  to  be  saved  from  that  stunted  growth  of 
the  mind  and  body,  which  premature  and  excessive  stimulation 
of  the  powers  of  reflection  and  memory  cannot  fail  to  produce. 

The  next  period  of  life  is  that  of  boyhood  or  girlhood— 
extending  from  the  7th  to  the  i4th  year  or  from  the  appear- 
ance of  the  permanent  teeth  to  puberty. 

A  child  seven  years  old  is  unable  to  attend  to  any  one  subject 
beyond  a  limited  time.  According  to  Mr.  Edwin  Chadwick 
a  pioneer  in  all  sanitary  and  social  reform,  a  single  lesson  be- 
tween the  ages  of  5  and  7  should  last  only  15  minutes';  between 
7  and  10  about  20  minutes  ;  from  10  to  12  about  25  minutes; 
12  to  1 6  about  30  minutes.  These  limits  are  too  restricted 
for  the  higher  ages  and  for  interesting  subjects,  but  the 
principle  involved  is  most  important. 

The  amount  of  work  should  always  be  carefully  graduated 
according  to  age.  For  children  from  7  to  8  years  old,  work 
should  not  last  longer  than  2\  to  3  hours  a-day  ;  from  8  to  10, 
from  3  to  32  hours ;  from  10  to  12,  about  4  hours  ;  from  12 


AGE    AND   SEX    IN    RELATION   TO   SCHOOL-WORK,  73 

to  15,  between  5  and  6  hours;  and  from  15  to  18,  never  more 
than  8  hours,  intervals  being  allowed  for  recreation. 

Mr.  Edwin  Chadwick  has  maintained  that  under  the  "  half- 
time  "  system,  children  make  as  good  progress  as  if  they 
attended  school  the  whole  day.  Whether  this  is  confirmed  or 
not,  there  can  be  no  question  that  the  alternation  of  directed 
manual  labour  (see  page  66),  with  shorter  periods  of  study, 
would  be  attended  with  the  greatest  advantage  to  the  mental 
and  physical  development  of  children. 

If  at  the  earlier  ages  more  than  3  hours'  work  is  required, 
the  work  becomes  too  exciting,  and  children  become 
prematurely  clever,  which  involves  great  risks  and  no  genuine 
gain.  Precocious  children  seldom  realise  the  promise  they 
gave. 

It  must  be  carefully  remembered  that  during  the  period  of 
school-life  gtou'th  and  development  of  every  organ  are,  under 
natural  conditions,  rapidly  proceeding,  and  that,  while  diligently 
cultivating  the  brain,  the  rest  of  the  body  must  not  be  neg- 
lected. There  is  to  some  extent  an  antagonism  between 
growth  (i.e.,  increase  in  size),  and  development  (i.e.,  increase  in 
structure).  The  undue  and  premature  elaboration  of  structure, 
as  in  mental  precocity,  involves  a  stoppage  or  diminution  of 
growth,  and  ultimately  a  feebler  brain.  *We  do  not  wish  it 
to  be  inferred  that  brains  should,  so  to  speak,  be  allowed  to 
lie  fallow  until  their  growth  is  completed,  and  then  have  their 
structure  elaborated  by  mental  education.  This  would  be  as 
impossible  as  it  is  undesirable.  We  only  wish  to  state  the 


*  For  a  very  valuable  detailed  discussion  of  this  and  other  mat- 
ters bearing  on  the  physiological  aspect  of  education,  see  the  article 
by  Sir  Crich ton  Browne,  M.D.,  on  "Education  and  the  Nervous 
System,''  in  Cassell's  Book  of  Health.  It  is  a  pity  that  this  Essay 
is  not  published  separately  for  the  use  of  teachers  and  others  in- 
terested in  the  subject. 


74  SCHOOL    HYGIENE. 

importance  of  not  over-exciting  the  juvenile  brain,  and  thus 
causing  it  to  fall  short  of  the  size  and  power  it  would  otherwise 
have  attained.  The  difference  has  been  well  stated  thus  : — At 
10  years  old  we  may  assume  the  brain  to  be  a  lo-carat  brain. 
Push  on  education  and  make  it  rapidly  the  24-carat  brain  it 
should  become  only  with  adult  life,  and  the  result  will  be  that 
the  total  value  obtained  owing  to  the  smaller  amount  of  brain 
will  be  much  less  than  if  the  forcing  system  had  not  been 
adopted. 

The  evil  results  of  undue  excitement  of  the  brain  during  the 
period  of  growth  are  not  confined  to  that  organ.  The  brain 
has  great  influence  over  all  other  functions  of  the  body.  A 
fastidious  appetite,  imperfect  digestion,  or  weak  circulation, 
followed  by  retarded  growth  of  body  and  general  enfeeblement, 
are  not  uncommon  results  of  hard  study,  when  insufficient 
time  is  allowed  for  recreation  and  other  purposes. 

It  would  be  well  if  every  parent  would  at  intervals  of  three 
months  or  even  oftener  have  his  children  weighed  and  mea- 
sured, keeping  a  record  of  the  result. 

Such  information  is  easily  obtained  and  would  be  of  im- 
mense value  in  warning  as  to  the  insidious  onset  of  disease,  or 
a  too  rapid  increase  in  stature,  It  is  well  known  that  when  a  boy 
is  growing  very  rapidly  his  powers  of  mental  application  be- 
come greatly  diminished.  He  is  dull  and  apathetic,  and  per- 
haps lays  himself  open  to  undeserved  censure,  which  might 
have  been  averted  had  the  parent  informed  the  teacher  of  the 
rapid  growth  and  consequent  necessity  for  diminution  of 
work.  Any  increase  in  size  beyond  2  to  3  inches  a  year  in- 
volving undue  strain  on  the  system,  or  any  sudden  stoppage  of 
growth  (indicating  perhaps  the  onset  of  consumption  or  other 
diseases,  especially  if  accompanied  by  diminished  weight) 
should  excite  apprehension  and  lead  to  medical  supervision. 

Stoppage  of  growth  or  of  increase  in  weight  might  be  due 


AGE    AND    SEX    IN    RELATION   TO   SCHOOL-WORK.  75 

(i)  to  insufficient  food  or  clothing,  the  food  being  icquired  to 
keep  up  the  temperature  of  the  body  and  no  svuplus  being  left 
for  purposes  of  growth  ;  or  (2)  to  excessive  mental  work  and 
deficient  exercise  in  the  open  air ;  or  (3)  to  the  onset  of  some 
disease.  In  -all  cases  it  requires  careful  attention  even  when 
no  other  indications  of  disorder  are  present.* 

Height  and  Weight  of  Children. — The  following  tables  give 
valuable  information  respecting  the  height,  weight,  and  rate 
of  growth  of  boys  and  girls.  They  are  taken  from  a  most 
valuable  paper  by  Dr.  Bowditch,  of  Harvard  University,  on 
"  The  Growth  of  Children,"  in  the  8th  Annual  Report  of  the 
Massachusetts  Board  of  Health  for  1877,  and  I  have  specially 
arranged  them  so  as  to  compare  boys  of  different  classes,  and 
•  boys  with  girls.  For  the  figures  contained  in  Table  I.,  Dr.  Bow- 
ditch  is  indebted  to  Mr.  C.  Roberts,  of  London.  In  each 


*  The  following  remarks  of  Mr.  Sharpe,  H.  M.  Inspector  of  Train- 
ing Colleges,  may  be  quoted  as  bearing  on  this  point  (Report  of 
Committee  of  Council  on  Education,  1885-6,  page  403) :--  '*  1  should 
recommend  to  other  colleges  a  practice,  so  far  as  I  know,  pursued 
by  only  one  training  college,  viz ,  Westminster,  the  weighing  of 
the  students  at  regular  intervals  and  recording  the  weights.  At  the 
beginning  of  the  year  1885,  all  the  students  (over  a  hundred  in  num- 
ber), with  only  three  exceptions  (all  of  them  in  their  second  year), 
increased  steadily  in  weight  The  annual  inspection  took  place  in 
the  fifth  month  ;  after  the  inspection  it  was  found  that  only  two  of 
the  second  year's  students  had  continued  to  increase  in  weight  (one 
of  whom  had  been  steadily  losing  weight  for  three  months  and  had 
begun  to  recover),  and  the  average  loss  in  weight  per  student 
during  the  few  weeks  preceding  the  examination  was  no  less  than 
3lbs.  The  experienced  vice-principal,  Mr.  Mansford.  has  no  doubt 
that  the  loss  of  weight  is  solely  attributable  to  the  anxietv  con- 
nected with  the  preparation  and  giving  of  lessons.  This  is  tneonly 
form  of  over- pressure  which  is  to  be  found  in  the  male  training 
colleges,  and  it  would  be  difficult  to  find  a  healthier  body  of  young 
men." 

I  may  add  that  in  the  same  college,  when  students  have  been 
found  for  two  or  three  months  to  decrease  in  weight  (the  usual  rule 
being  a  steady  increase),  I  have  been  asked  to  examine  into  their 
physical  condition.  In  several  cases  this  has  led  to  the  early  de- 
tection of  disease,  and  in  this  way  a  break- down  has  been  prevented. 


SCHOOL   HYGIENE. 


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78  SCHOOL   HYGIENE. 

table  the  heights  are  measured  without  shoes,  and  the  weights 
in  ordinary  in-door  clothing. 

Many  important  particulars  can  be  gathered  from 
these  tables.  Thus  the  relationship  which  should  hold 
between  growth  in  height  and  increase  in  weight  is  easily 
calculated. 

The  ages  at  which  growth  is  most  rapid  are  easily  seen. 
The  greatest  annual  increase  of  height  occurs  for  girls  at  1 2, 
and  for  boys  at  16  years.  The  greatest  increase  of  weight  foi 
boys  occurs  at  16,  and  for  girls  at  13  years. 

The  influence  of  town  life  and  labouring  class  is  seen  in  the 
lower  stature  at  all  ages  of  children  of  this  class.  The  most 
favoured  class  has  a  mean  height  2  inches  greater  than  the 
industrial  class,  the  difference  attaining  a  maximum  of  over  4 
inches  at  13  years  of  age. 

Dr.  Bowditch  summarises  his  results  as  follows  : — (i)  During 
the  first  twelve  years  of  life  boys  are  from  i  to  2  inches  taller 
than  girls  of  the  same  age.  (2)  At  about  12^  years  of  age, 
girls  begin  to  grow  faster  than  boys,  and  during  their  i4th  year 
are  about  one  inch  taller  than  boys  of  the  same  age.  (3)  At 
about  145  years  boys  again  become  the  taller,  girls  having  at 
this  period  very  nearly  completed  their  growth,  while  boys 
continue  to  grow  rapidly  till  19  years  of  age. 

The  same  general  results  have  been  obtained  in  England, 
Mr.  C.  Roberts  finding  that  girls  of  13  years  are  as  a  rule 
taller  and  heavier  than  boys  at  the  same  age. 

The  bearing  of  the  different  rates  of  growth  in  the  two  sexes 
on  the  methods  of  heal; hy  education  will  be  discussed  in  the 
next  paragraph. 

The  following  chart  has  been  copied  by  permission  of 
Messrs.  Macmillan  from  the  "  Life  History  Album,"  edited  by 
F.  Galton,  F.R.S.  It  illustrates  graphically  the  same  facts  as 
have  been  given  in  the  preceding  tables,  and  the  observations, 


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it     £     84      b     0     7     8     0    10   11    12    13   14  16   16  17   18   19  20  21    22  23   24  2 
3.  18.—  Chart  showing  average  stature  weight,  chest  girth,  and  strengtl 

both  s^xes.  from  birth  to  25  years  of  age,  of  the  general  population  of  the 
United  Kingdom. 

Males  —  Females 

For  "stature  without  shoes  in  Ibs.,'    read  inchu* 


80  SCHOOL    HYGIENE. 

although  derived  from  a  different  source,  support  the  same 
general  conclusions. 

Sex  in  Education. — Most  of  what  has  been  already  stated 
concerning  the  bearings  of  age  on  school-work  applies  equally 
to  boys  and  girls.  It  is  important  to  remember  however  that, 
as  already  stated,  while  growth  of  boys  continues  till  man- 
hood, girls  concentrate  a  great  deal  of  growth  in  a  few  years. 

Owing  to  the  relatively  greater  growth  of  girls  from  12^  to 
14^  or  15,  it  is  particularly  important  that  their  height  and 
weight  should  be  watched  during  this  period,  and  any  over-strain 
from  examinations  or  other  source  avoided.  A  stoppage  of  in- 
crease in  weight  or  height  should  receive  immediate  at- 
tention, and  even  more  important  a  continuance  of  growth  in  a 
girl  who  has  ceased  to  become  heavier  may  be  one  of  the 
earliest  indications  of  threatened  consumption. 

The  period  of  puberty  involves  greater  and  more  rapid 
changes  in  girls  than  in  boys,  and  schooling  requires  to  be 
carefully  regulated  at  this  period.  Accompanying  the  changes 
in  other  organs,  great  changes  must  occur  in  the  brain, 
new  emotions  and  new  phases  of  mental  activity  being 
developed.  That  the  nervous  system  is  unstable  at  this  period 
is  shown  by  the  large  amount  of  epilepsy  which  starts 
about  puberty,  and  the  still  larger  amount  of  hysteria. 
Insanity  again  is  not  uncommon  after  puberty,  very  rare 
before  it. 

The  Massachusetts  Board  of  Health  in  1874  issued  a  cir- 
cular asking  teachers,  physicians,  &c.,  whether  they  found  that 
puberty  increased  the  liability  to  suffer  from  school  attendance. 
Of  141  answers  received,  120  were  in  the  affirmative.  It  is 
probable  that  a  carefully  regulated  school  education  is  benefi- 
cial to  girls  of  14  to  17  rather  than  otherwise,  and  that  the 
effects,  which  are  sometimes  ascribed  to  school-work,  are  more 
commonly  due  to  defective  exercise,  late  hours,  and  bad  at- 


AGE   AND   SEX   IN    RELATION   TO  SCHOOL-WORK.  8l 

mospiiere,  and  the  excitement  of  novels,  or  of  a  premature 
entry  into  society.  An  amount  of  mental  work,  which  would 
be  health'ul  if  followed  by  active  and  pleasant  exercise,  may 
be  injurious  when  exercise  is  confined  to  a  walk  to  and  from 
school  unaccompanied  by  any  "  play." 

Undue  devotion  to  music  seems  to  have  a  specially  exciting 
influence  on  some  girls,  and  prolonged  musical  exercises  are 
never  desirable.  Emulation  in  connection  with  examinations 
is  much  more  likely  to  be  injurious  to  girls  than  to  boys. 

At  certain  periods  many  physicians  assert  that  school  atten- 
dance should  be  temporarily  suspended.  We  are  not  inclined 
to  take  this  view  in  the  majority  of  cases.  Home  lessons 
should  be  diminished,  long  walks  or  calisthenics  should 
be  stopped,  and  excitement  should  be'  avoided ;  but,  as  a  rule, 
school  attendance  will  do  no  harm. 

Character  of  Education  in  relation  to  Sex. — Two  opposite 
schools  of  thought  have  been  vigorously  advocated.  It  is  the 
opinion  of  one  that  school  education  should  be  specially 
adapted  to  the  peculiarities  of  each  sex,  while  advocates  of  the 
other  school  strongly  insist  on  equal  and  like  education  of  the 
txvo  sexes.  Dr.  Clarke,  in  his  essay  on  Sex  in  Education,  says  : 
"None  doubt  the  importance  of  age,  acquirement,  idiosyncrasy 
and  probable  career  as  factors  in  classification.  Sex  goes 
deeper  than  any  of  these."  We  are  inclined  to  admit  the 
justice  of  this,  though  laying  a  little  more  stress  on  the  con- 
sideration tliat  education  should  be  adapted  to  the  individual 
rather  than  to  the  sex.  If  this  consideration  be  kept  in  mind, 
the  absurdity  of  pressing  on  girls  the  study  of  higher  mathema- 
tics, or  the  severer  sciences,  will  be  evident.  Doubtless  most 
girls  are  quite  competent  for  these  studies,  if  taken  in  modera- 
tion and  with  due  consideration  for  the  physical  system,  but 
the  necessity  for  them  is  absent,  and  the  time  would  be  much 
better  spent  in  developing  a  robust  physical  frame,  competent 

G 


82  SCHOOL   HYGIENE. 

for  the  practical  functions  of  life.  The  painter  who  used  up 
all  his  colours  ior  his  background,  and  left  none  for  the  por« 
trait,  is  an  apt  illustration  of  the  over-educated  school-girl,  lack- 
ing in  practical  knowledge  and  physique. 

The  female  temperament  is  more  nervous  and  excitable  than 
the  male,  and  the  opportunities  for  counteracting  the  effects  of 
mental  work  by  vigorous  muscular  exertion  are  fewer.  The 
evils  of  over-strain  occur  chiefly  in  girls  between  13  and  18, 
and  much  danger  would  be  averted  if  the  considerations  re- 
specting exercise,  to  be  advanced  in  the  next  chapter,  were , 
acted  on  in  their  case. 


CHAPTER  XII. 
MUSCULAR  EXERCISE  AND  RECREATION. 

Analogy  between  Menial  and  Muscular  Exercise. — Influence  of 
Exercise  on  the  System.— Influence  on  the  Brain— Excessive  Exer- 
cise.—Deficient  Exercise.— Rules  for  Exercise— Form*  of  Exercise 
— Gymnastics.—  Calisthenics. 

THE  voluntary  muscles  of  the  body  contain  in  their  substance 
about  one-fourth  of  the  whole  volume  of  blood,  and,  even  dur- 
ing their  rest,  important  heat-producing  and  other  functions 
are  carried  on  in  them,  though  these  are  rendered  much  more 
active  by  exercise. 

Much  of  what  has  been  said  concerning  brain  exercise 
applies  equally  to  the  muscles.  Just  as  the  powers  of  memory, 
observation,  judgment,  speech,  &c.,  increase  by  careful  cultiva- 
tion, so  does  muscular  power  The  brain  is  temporarily 
exhausted  by  fatigue,  and  so  are  the  muscles ;  it  may  be  per- 
manently injured  by  excessive  and  prolonged  exertions,  and  so 
likewise  may  the  muscles,  especially  the  heart-muscle. 

Muscular  exercise  is  important  during  school-life,  because 
of  its  influence  (i)  on  the  general  health,  and  (2)  on  the 
brain. 

83 


SCHOOL   HYGIENE. 


(i.)  In  consequence  of  the  increased  size  and  strength  of 
the  muscles  produced  by  systematic  exercise,  they  respond 
more  easily  to  impulses  of  the  will.  The  action  of  the  lungs  is 
increased,  and  consequently  more  pure  air  is  inhaled,  and 
more  impurities  are  got  rid  of,  while  ihe  actual  capacity  of  the 
lungs,  as  indicated  by  the  girth  of  the  chest,  becomes  increased 
by  well  regulated  exercise.  In  this  way  a  flat-chested  condi- 
tion may  be  averted,  and  a  tendency  to  consumption  may  be 
eradicated.  The  action  of  the  skin  is  increased,  and  thus 
another  means  of  elimination  of  impurities  is  set  at  work.  The 
circulation  is  improved  and  rendered  more  uniform,  and  the 
production  of  heat  is  increased  during  exercise,  in  consequence 
of  which  cold  feet  and  chilblains  are  avoided. 

The  following  tables  from  Maclaren's  "  Physical  Education  " 
strikingly  illustrate  the  valuable  results  obtainable  from  syste- 
matic gymnastic  exercises. 

The  first  table  shows  the  effect  of  7^  months'  training  of  men 
varying  in  age  from  19  to  28,  the  average  age  being  24,  the 
men  having  been  irregularly  selected. 


Weight. 

Chest 
girth. 

Girth  of 
fore-arm. 

Girth  of 
upper  arm 

Ibs. 

in. 

in. 

in. 

The  smallest  Gain   ... 

5 

I 

i 

i 

The  largest  Gain     ... 

16 

5 

u 

T  3 
J? 

The  average  Gain    ... 

10 

2l 

I 

12 

The  second  table  shows  the  effect  on  two  articled  pupils, 
aged  1 6  and  20,  of  a  year's  steady  practice  in  gymnastic  exer- 
cises. 


MUSCULAR   EXERCISE   AND   RECREATION. 


In  the  year's  work  the  increase  was — 


Height. 

Weight. 

Chest. 

Fore- 
Arm. 

Upper 
Ann. 

With  the  younger   .... 

in. 

2 

Ibs. 

21 

in. 

in. 

2 

in. 

2 

With  the  elder    . 

a 

8V 

6 

li 

iV 

(2.)  During  the  period  of  school-life  the  brain  and  muscles 
are  both  undergoing  growth  and  development  They  cannot 
be  separated  from  one  another,  being  intimately  in  communica- 
tion by  means  of  nerves.  There  is  a  motor  part  of  the  brain 
corresponding  to  the  muscles,  in  which  are  stored  ideas  of 
weight,  distance,  resistance,  the  result  of  muscular  contractions ; 
and  from  which  are  carried  the  voluntary  impulses  which  result 
in  muscular  exercise.  This  extensive  region  of  the  brain  is  in 
intimate  communication  with  all  the  other  regions  of  the  brain, 
and  at  the  same  time  it  can  attain  its  full  vigour  only  when  the 
whole  muscular  system  is  in  a  well  developed  and  healthy  con- 
dition. It  is  a  well-known  fact  that  each  nervous  centre 
requires  external  stimuli  to  develop  its  potential  power.  If  a 
number  of  chickens  are  hatched  on  a  carpet  they  will  run 
about  and  never  attempt  to  scratch  until  a  little  gravel  is 
scattered  on  it.  In  two  cases  the  congenital  absence  of  the 
left  hand  and  atrophy  of  I  he  left  arm  was  found  after  death  to 
be  associated  with  an  atrophied  condition  of  the  convolution 
of  the  brain,  in  which  movements  of  the  hand  are  stated  by 
Ferrier  to  be  produced.  But  where  death  has  occurred  some 
years  after  amputation  of  the  limb  of  an  adult,  no  alteration  in 
the  corresponding  part  of  the  brain  has  been  found.  Hence 
the  greater  importance  of  exercise  before  twenty  than  after  thru 
age.  The  blindness  of  the  fishes  living  in  the  dark  caves  of 
Kentucky  is  another  instance  of  atrophy  of  a  disused  organ, 
and  of  the  corresponding  part  of  the  brain. 


86  SCHOOL   HYGIENE. 

The  above  considerations  render  it  evident  that  the  de- 
velopment of  a  considerable  portion  of  the  brain  is  dependent 
on  muscular  exercise,  and  the  non-recognition  of  this  prin- 
ciple has  been  saved  from  calamitous  results  in  the  past,  only 
by  the  instinctive  revelling  of  children  in  movements  of  every 
kind. 

Excessive  muscular  exercise  produces  fatigue.  If  proper 
intervals  of  rest  are  not  allowed  this  may  end  in  serious 
disease,  though  such  a  result  chiefly  occurs  when,  as  in  clerks, 
a  small  group  of  muscles  is  over-worked,  and  writer's  palsy  is 
produced. 

Violent  over- exertion,  such  as  occurs  in  competitive  run- 
ning or  rowing,  is  very  pernicious.  The  "broken  winded" 
condition  in  horses  is  produced  in  a  similar  way.  Occasionally 
the  heart  becomes  dilated,  or  spitting  of  blood  is  produced. 
Competitive  exercises  always  require  careful  and  graduated 
preparation,  and  no  boy  should  be  allowed  to  join  in  them 
without  previous  medical  examination. 

We  do  not  wish  our  sons  to  become  as  muscular  as  Hercules 
from  over-muscular  development,  nor  to  be  nervous  and 
excitable  and  under-grown  from  the  opposite  condition,  but 
to  have  their  muscular  and  nervous  systems  healthy  and  in 
proper  co-ordination.  There  is  no  necessary  antagonism 
between  mental  culture  and  athleticism,  except  when  the 
latter  is  indulged  to  excess. 

The  danger  of  excessive  exercise  is  greatest  during  the 
period  of  most  rapid  growth  between  the  ages  of  15  and  17. 
Excessive  muscular  exercise  may  then  interfere  with  growth, 
though  deficient  exercise  is  to  be  deprecated.  Sometimes  a 
boy  at  school  grows  from  6  to  8  inches  in  a  year,  and  it  is 
evident  that  ail  his  strength  is  being  expended  in  this 
direction. 

Deficient   exercise    during  school-life   is   much   commoner 


MUSCULAR    EXERCISE   AND   RECREATION.  87 

than  excessive  exercise,  especially  in  girls.  The  general 
health  is  consequently  impaired,  digestion  is  enfeebled,  the 
circulation  becomes  unequal,  and  nervous  irritability  and 
sleeplessness  often  supervene.  The  tendency  to  lung  diseases, 
especially  consumption,  is  greatly  increased.  The  effects  on 
the  figure  are  lamentable.  Drooping  shoulders,  a  flat  chest, 
stooping  gait,  and  lateral  curvature  of  the  spine  are  natural 
consequences  of  flabby  muscles  destitute  of  tone.  In  girls 
the  tendency  to  spinal  curvature  is  increased  by  the  tight 
imprisonment  of  the  trunk  in  corsets  which  effectually  pre- 
vent exercise  of  the  trunk  muscles.  For  girls  who  are  grow- 
ing rapidly,  the  use  of  Liebreich's  chair,  which  is  adapted  to 
the  curves  of  the  spinal  column,  and  gives  complete  rest  to  the 
spine,  is  very  valuable.  (Fig.  19).  Reading  or  other  work  can  be 
continued  while  resting  in  the  chair.  The  alternation  of  such 
rest,  with  exercises  specially  adapted  to  strengthen  the  mus- 
cles of  the  back  and  shoulders,  is  most  important  in  all  cases 
where  there  is  a  tendency  to  spinal  curvature,  or  drooping 
shoulders,  or  a  forward  stoop. 


FIG  19.— Chair  giving  complete  spinal  support. 


88  SCHOOL   HYGIENE. 

In  taking  exercise  the  following  rules  should  be  regarded. 
The  clothing  should  allow  free  play  of  the  limbs,  and  ex- 
pansion of  the  chest,  flannel  being  always  worn  next  the  skin. 
Chill,  which  is  so  often  produced  by  sitting  in  a  draught  after 
perspiration,  must  be  carefully  avoided.  The  exercise  must 
be  systematic  and  regular,  and  never  sudden  and  violent,  and 
the  amount  of  exercise  must  be  regulated  by  individual  fitness. 
Every  part  of  the  body  must  be  exercised.  Exercise  must  not 
be  taken  directly  after  meals. 

It  should  as  far  as  possible  be  taken  in  the  open  air.  The 
fact  that  the  amount  of  air  inspired  during  exercise  is  greatly 
increased  serves  to  emphasise  this  rule,  and  explains  why  the 
benefit  of  girls'  calisthenics  is  greatly  diminished  by  their  being 
commonly  taken  indoors. 

Forms  of  Exercise. — If  there  is  one  point  more  important 
than  another  it  is  that  exercise  should  be  as  varied  as  possible. 
The  spontaneous  activity  of  children  is  more  conducive  to 
general  strength  and  healthy  brain-growth  than  any  formal 
gymnastics.  The  latter  can  never  form  a  complete  substitute 
for  games.  The  movements  are  more  rigid,  and  less  varied,  and 
consequently  sooner  produce  fatigue,  and  the  competition 
which  serves  for  a  stimulus  in  gymnastics  is  a  very  poor  sub- 
stitute for  the  enjoyment  accompanying  varied  play.  The 
enjoyable  mental  excitement  of  games  acts  as  a  stimulant  and 
tonic  to  the  heart,  accelerating  the  circulation  and  helping  all 
the  bodily  functions. 

The  more  purely  recreative  physical  exercise  is,  the 
greater  the  relief  from  school-work.  The  tendency  to  provide 
play-grounds  of  insufficient  size  is,  in  this  connection,  very 
deplorable,  though,  when  this  is  unavoidable,  gymnastics  should 
be  resorted  to. 

Running,  leaping,  rowing,  swimming,  cricket,  rackets,  tennis, 
&c.,  all  have  their  place,  and  are  deservedly  popular.  Boating 


MUSCULAR   EXERCISE   AND   RECREATION.  89 

should  De  restricted  to  those  who  can  swim.  Football  scrim- 
mages should  not  be  allowed,  and  the  ball  should  never  be 
taken  in  the  hands.  A  belt  should  never  be  allowed  round  the 
waist,  being  one  of  the  commonest  causes  of  rupture. 

Singing,  speaking,  and  reading  aloud  are  forms  of  muscular 
exercise  which  might  with  advantage  be  more  systematically 
adopted.  They  are  most  valuable  in  strengthening  the  throat 
and  lungs,  and  rendering  them  less  prone  to  disease. 

Gymnastics  were  carefully  studied  in  ancient  times,  the 
Greeks  having  a  perfect  system,  which  was  adopted  by  the 
Romans  to  a  certain  extent,  though  not  in  its  best  aspects,  and 
among  them  was  confined  to  the  military  class  and  athletes. 
The  best  modern  system  is  Ling's,  or  the  Swedish  system, 
which  is  founded  on  anatomical  data,  and  does  not  seek  merely 
muscular  development,  but  a  general  improvement  of  circu- 
lation and  nerve  power,  all  the  parts  being  brought  into 
balanced  action. 

Gymnastic  exercises  should  be  adapted  to  the  age  and  phy- 
sical constitution  of  each  pupil.  Much  injury  may  be  done  by 
making  all  the  members  of  a  class  go  through  the  same  exercises. 
Up  to  the  age  of  15  or  1 6  such  light  gymnastic  exercises  as  are 
described  and  illustrated  in  "  Sound  Bodies  for  our  Boys  and 
Girls,"  by  W.  Blaikie,  if  carried  out  under  the  superintendence 
of  a  skilled  teacher,  are  amply  sufficient,  and  obviate  the 
necessity  for  any  complicated  apparatus.  After  this  age  a 
more  advanced  course  of  gymnastic  exercises  may  be  the 
means  of  laying  the  foundation  of  permanent  health  and 
strength. 

Military  drill  is  a  useful  addition  to  school  routine.  It 
serves  not  only  to  teach  order  and  promptitude  of  obedience, 
but  is  a  valuable  means  of  exercise. 

Exercise  for  Girls  in  the  form  of  gymnastics,  or  the  school- 
girls' gymnastics,  known  as  calisthenics,  is  even  more  important 


90  SCHOOL   HYGIENE. 

than  for  boys,  inasmuch  as,  especially  in  towns,  there  are  for 
them  fewer  opportunities  of  play,  and  they  suffer  trom  improper 
modes  of  dressing. 

The  only  advantage  calisthenics  presents  over  play  is  that  it 
ensures  an  equal  and  regular  exercise  of  muscles. 

It  is  important,  however,  that  it  should  be  made  interesting, 
otherwise  much  of  the  benefit  is  lost.  By  the  use  of  dumb- 
bells (which  should  not  exceed  2  to  4  Ibs.  for  girls),elastic  bands 
with  handles,  &c.,  many  varied  exercises  can  be  performed. 

Girls  suffer  much  more  on  account  of  deficient  recreation 
than  boys.  The  formal  boarding-school  walk  on  fine  days  is 
but  a  travesty  on  the  exercise  required,  and  has  little  effect  in 
stimulating  the  circulation,  or  refreshing  the  mind.  A  recess 
of  half  an  hour  should  be  allowed  in  the  middle  of  each  morn- 
ing's school-work,  during  which  every  girl  should  be  obliged 
to  go  out  and  play  in  fine  weather,  or  assemble  for  calisthenics 
in  wet  weather.  It  should  be  made  impossible  to  think  of 
work  during  this  half-hour. 


CHAPTER    XIII. 
REST  AND  SLEEP. 

Law  of  Rest  and  Action.— Partial  Rest.— Complete  Rest.— Duration 
of  Sleep.  —Rules  respecting  Sleep.— School  Dormitories. 

LIFE  is  made  up  of  alternations  of  rest  and  action.  Exer- 
cise of  any  organ  of  the  body  is  followed  by  a  necessary  period 
of  repose,  during  which  effete  matters  are  removed  by  the 
blood,  and  flesh  nutritive  material  is  supplied  by  the  same  fluid. 

The  only  apparent  exceptions  are  the  heart  and  lungs,  and 
these  in  reality  obey  the  universal  law,  the  only  difference 
being  that  their  rest  is  frequent  and  momentary,  while  that  of 
other  organs  is  at  greater  intervals  and  of  longer  duration. 

The  heart,  for  instance,  contracts  about  once  every  second, 
but  in  the  intervals  of  each  contraction  it  rests  -fa  of  a  second, 
or  over  13  hours  in  the  day. 

The  necessity  for  rest  can  be  easily  proved  in  the  case  of 
the  sense  of  taste.  If  salt  be  kept  in  the  mouth  for  a  consider- 
able time,  the  power  of  tasting  it  disappears,  and  returns  in  its 
original  strength  only  after  several  hours.  The  temporary 
deafness  from  the  noise  of  machinery,  and  the  fact  that  after 
looking  at  a  given  colour  for  some  time,  only  its  complemen- 
tary colour  is  visible,  are  other  instances  of  the  same  law. 

Rest  may  be  partial  or  general. 


92  SCHOOL   HYGIENE. 

Partial  rest  is  obtained  by  change  of  occupation,  bringing 
into  play  the  activity  of  other  organs. 

The  importance  of  varying  school-work  at  frequent  intervals, 
thus  exercising  different  parts  of  the  brain,  has  been  already 
discussed  (see  page  66).  Similarly  in  the  last  chapter  we  have 
emphasized  the  importance  of  recreative  muscular  exercise.  By 
these  two  means,  undue  pressure  of  school-work  may  nearly 
always  be  prevented. 

Sleep  is  the  only  form  of  complete  and  general  rest.     During 
sleep  a  diminished  amount  of  blood  flows  through   the  brain, 
and  the  functional  activity  of  its  higher  centres  is  abrogated. 
If  a  boy  or  girl  eats  and  sleeps  well,  it  can  scarce  be  that  his 
brain  is  over-worked.  It  is  a  mistake,  however,  to  suppose  that 
the  evils  of  excessive  mental  work  can  be  entirely  compensated 
by  prolonging  sleep.     The  mental  work  must  be  diminished, 
and  more  time  must  also  be  allowed  for  recreation. 
The  average  amount  of  sleep  required  at — 
4  years  old  is  12  hours. 
7        „  ii        » 

9         »  I0i      » 

12-14         „         9-10        „ 
14-21         „  9       „ 

Children  under  14  should  be  allowed  a  little  more  sleep  in 
winter  than  in  summer,  and  when  growing  very  fast.  Punctuality 
in  the  time  of  sleep  is  of  great  importance,  owing  to  the  habit 
acquired.  Great  drowsiness  or  wakefulness  in  children  should 
always  be  looked  into.  The  night  screamings  to  which  some 
children  are  liable  may  indicate  overwork  at  school,  but 
generally  they  occur  apart  from  school-work  in  children  of  a 
very  nervous  temperament. 

The  regulation  of  children's  sleep  is  a  matter  which  chiefly 
lies  with  parents,  and  they  may  greatly  help  the  school-teacher 
by  attention  to  it.  It  is  unfortunate  that  growing  boys  and 


REST  AND   SLEEP.  93 

\ 

girls  are,  especially  in  winter,  so  frequently  taken  to  concerts  or 
other  evening  meetings.  No  wonder  that  they  appear  next 
morning  at  school  with  dark  rings  about  their  eyes,  and 
generally  incapacitated  for  mental  application. 

The  importance  of  sleeping  in  a  pure  atmosphere,  and  of 
having,  during  winter,  a  flannel  jacket  or  other  warm  covering 
to  the  arms  and  shoulders,  need  only  be  referred  to. 

School  Dormitories  should  never  be  used  during  the  day  for 
study  or  other  purposes,  as  thus  the  atmosphere  is  rendered 
impure,  and  irregular  habits  are  induced.  The  windows 
should  be  kept  widely  open  during  the  day  in  order  to  ensure 
a  thorough  and  prolonged  sweep  of  fresh  air  through  the 
rooms.  Large  and  airy  bedrooms  are  very  desirable,  as  thus 
the  rooms  can  be  more  thoroughly  ventilated  and  the  pupils 
better  supervised. 

The  same  rules  for  ventilation  and  warming  apply  as  in  the 
case  of  the  school-rooms.  It  is  obvious  that  inasmuch  as  the 
pupil  passes  at  least  one-third  of  each  day  in  his  bedroom,  its 
atmosphere  should  be  as  pure  as  possible.  Even  with  the 
best  means  of  ventilation  this  cannot  be  secured,  unless  a 
sufficient  cubic  space  is  allowed  for  each  pupil.  The  Govern- 
ment insists  on  300  cubic  feet  for  each  pauper  in  our  work- 
houses. Surely,  at  least  this  amount  might  be  allowed  in 
boarding-schools ;  whereas  beds  are  frequently  placed  almost, 
or  quite,  in  contact,  and  such  overcrowding  occurs  as,  if  it 
happened  in  a  common  lodging-house,  would  lead  to  the 
prosecution  01  the  landlord.  We  have  seen  (page  27)  that  not 
less  than  1500  cubic  feel  of  fresh  air  are  required  by  each  pupil 
per  hour.  But  if  the  air  is  changed  more  than  three  or  four 
times  per  hour,  violent  draughts  are  produced.  It  follows, 
therefore,  that  from  375  to  500  cubic  feet  of  space  should  be 
allowed  for  each  scholar  in  the  bedroom,  and  preferably  the 
latter  amount  Masters  will  assert  that  the  ventilating 


94  SCHOOL   HYGIENE. 

arrangements  they  have  introduced  obviate  the  necessity  for 
this  amount  of  space.  This  is  nearly  always  inaccurate  ;  and 
even  if  it  were  theoretically  true,  children  (as  well  as  their 
seniors)  will  close  up  any  orifice  from  which  an  unpleasant 
draught  is  perceptible.  Dr.  Dukes,  the  Physician  to  Rugby 
School,  urges  that  taking  a  school-bed  at  3  by  6  feet,  the 
superficial  area  of  the  bedroom  should  be  6  by  1 2  feet  per 
pupil,  and  the  room  12  feet  high.  This  gives  864  cubic  feet 
per  head,  which,  allowing  for  the  air  displaced  by  the  furniture 
of  the  room  and  the  boy  himself,  leaves  about  800  cubic  feet 
per  head.  The  poor  health  and  pale  appearance  of  children 
at  boarding-schools  are  much  oftener  due  to  crowded  bedrooms, 
than  to  insufficient  or  inferior  food,  or  to  overwork. 

Each  pupil  should  have  his  own  towel  and  brush  and  comb. 
The  interchange  of  these  frequently  leads  to  the  spread  of 
ringworm,  or  of  contagious  affections  of  the  eye. 


CHAPTER      XIV. 
CHILDREN'S  DIET. 

Quantity  and  Quality  of  Food. — Food  required  for  Growth.— -Rela- 
tion of  Food  to  Work.— Frequency  oj  Under-feeding. — Amount 
of  Food  Required. 

THE  diet  of  children  should  be  generous  and  abundant. 

There  is  no  danger  of  giving  too  much  food,  if  none  but  simple 
and  wholesome  dishes  are  allowed.  After  40  it  may  be  broadly 
said  that  the  chief  danger  in  regard  to  diet  is  of  over-feeding, 
under  20  of  under-feeding.  It  must  be  remembered  that 
during  youth,  and  up  to  the  age  of  25,  physiological  processes 
are  much  more  active  than  at  a  later  period  ;  freer  exercise  is 
usually  taken,  and,  in  addition,  food  is  required  not  only  to 
supply  force  for  carrying  on  the  functions  of  the  body,  but  also 
for  purposes  of  growth.  Children  have  to  make  new  tissues 
as  well  as  to  keep  in  repair  those  already  established.  Also  as 
their  bodies  expose  more  surface,  in  proportion  to  size,  than 
adults,  they  require  a  proportionately  larger  amount  of  food 
to  compensate  for  loss  of  heat. 

It  is  only  after  waste  of  tissues  and  heat  loss  have  been  pro- 
vided for,  that  any  surplus  of  nutriment  goes  to  the  further 
growth  of  the  body.  Given  that  the  food  supply  is  scanty,  one 
of  two  things  must  happen  :  growth  will  be  impeded,  and  chil- 
dren will  be  stunted  specimens  of  humanity  \  or  some  of  the 
95 


96  SCHOOL   HYGIENE. 

organs  of  the  body,  as  the  brain,  or  muscles,  or  bone,  wftl  suffer 
in  functional  activity,  and  may  eventually  become  the  actual 
seat  of  disease. 

The  younger  an  animal,  the  more  easily  is  it  starved;  and 
the  more  actively  growing  are  its  organs,  the  more  seri- 
ously injured  by  starvation ;  and  the  same  applies  to  human 
beings. 

Apart  from  the  food  required  for  growth  and  development, 
the  close  relationship  between  food  and  work  must  not  be  for- 
gotten in  the  case  of  children  as  well  as  of  the  adult.  Work 
can  no  more  be  done  by  a  child  without  food  than  by  a  steam- 
engine  without  fuel.  The  more  brain-work  a  child  does, 
the  more  food  he  uses  up.  It  is  a  great  fallacy  to  suppose  that 
food  is  less  necessary  for  the  brain-worker  than  for  the  navvy. 
Each  metabolises  (roughly  speaking — oxidises)  a  large  amount 
of  combustible  material,  which  must  be  supplied  by  food. 
The  navvy,however,commonly  acquires  his  combustible  material 
with  greater  ease  than  the  brain-worker,  owing  to  his  better 
digestion. 

Hence  the  importance  of  not  allowing  half-starved  children 
to  be  unduly  burdened  with  mental  work  is  evident.  Even 
though  they  may  with  an  effort  succeed  in  their  studies,  it  is  at 
the  expense  of  a  diminutive  stature  and  feeble  muscles.  It  is 
to  be  hoped  that  the  practice  of  giving  penny  dinners  to  chil- 
dren of  Board  Schools  in  poorer  districts  may  extend.  A  still 
better  plan  would  be  to  give  them  a  mug  of  milk  and  slice  of 
bread  before  the  morning's  work  begins. 

It  is  unhappily  the  case  that  the  children  even  of  wealthy 
people  are  frequently  underfed.  A  certain  amount  is  appor- 
tioned at  each  meal,  and  a  lecture  on  the  evils  of  greediness 
follows  a  request  for  more.  We  hold  that  a  healthy  child's 
appetite  is  the  best  guide  as  to  the  amount  of  food  required,  if 
only  the  food  is  plain  and  wholesome.  He  might  surfeit  him- 


CHILDREN  S   DIET  97 

self  with  rich  pastry,  or  cakes,  but  hardly  with  porridge  and 
milk. 

The  danger  of  under-feeding  is  especially  great  among  girls, 
a  good  appetite  being  not  uncommonly  regarded  by  them  as 
something  to  be  ashamed  of.  Girls  between  the  ages  of  14  and 
20  often  suffer  from  a  species  of  chronic  starvation,  having  got  in- 
to the  habit  of  relying  on  bread  and  butter  and  puddings,  to  the 
almost  complete  exclusion  of  meat,  or  other  nitrogenous  fi  M. 
Much  weakness  and  ill-health  in  after  life  are  ascribable  to 
this  cause. 

According  to  Dr.  De  Chaumont  (Conference  on  School 
Hygiene  at  Health  Exhibition),  for  a  child  weighing  looibs. 
(who  would  probably  be  15  years  old,  see  chart,  page  79), 
about  3  ozs.  of  albuminate  (flesh-producing)  food,  2^  ozs.  ot 
fat,  1 2  ozs.  of  carbohydrates  (starch  and  sugar),  and  about  f  oz. 
of  mineral  matter  are  required  per  diem.  In  order  to  obtain 
the  above  amount  of  albuminate  material,  6  ozs.  of  meat  would 
be  required,  unless  cheese,  legumens  (beans,  peas,  &c.),  or  rnilk 
are  freely  taken.  It  may  be  convenient  to  remember  that 
bread  contains  about  8  per  cent,  albuminates  (and  50  per  cent, 
starch),  meat  15  per  cent,  albuminates,  cheese  over  30  per  cent, 
and  peas  and  beans  generally  22  per  cent  Most  dietaries  con- 
tain abundance  of  starch  and  sugar,  but  are  deficient  in  fat.  This 
deficiency  is  a  most  important  matter.  If  children  will  not  eat  the 
fat  of  meat,  then  dripping,  butter,  and  suet  puddings  are  useful. 

Children's  diet  should  be  varied  and  palatable.  The  intervals 
between  mea's  should  be  regular  and  not  too  long.  The  food 
should  not  be  allowed  to  be  bolted,  but  carefully  chewed. 
Milk  should  form  an  important  part  of  all  children's  diet, 
Alcohol  should  not  be  given  in  any  form,  unless  under  medical 
responsibility.  The  teeth  should  be  carefully  supervised  ;  over- 
crowding of  the  permanent  teeth  should  be  prevented  by  the 
dentist's  aid,  and  cavities  should  receive  early  attention. 
H 


98  SCHOOL   HYGIENE. 

The  water  supplied  at  school  should  be  pure,  and  absolutely 
above  suspicion.  Impurities  may  be  due  to  its  being  derived 
from  an  impure  source,  as  a  shallow  well,  or  to  impurities 
acquired  in  transit  through  the  pipes,  or  to  the  cistern  allowing 
contamination  of  the  water,  either  through  its  being  uncovered, 
or  having  its  waste-pipe  connected  with  some  part  of  the 
drainage  system.  The  filter  should  be  frequently  cleansed, 
or  it  may  do  more  harm  than  good. 


CHAPTER    XV. 
CHILDREN'S  DRESS. 

Amount  of  Clothing  required.— Relation  of  Clothing  to  Food. —  The 
Hardening  Process.-  Distribution  of  Clothing. — Rules  respecting 
Clothing. 

A.  CERTAIN  temperature  of  the  surface  of  the  body  (about 
g8'5  Fahr.)  is  necessary  for  the  maintenance  of  health,  and 
from  this  it  never  varies  more  than  18.  This  temperature  is 
the  result  of  the  chemical  processes  going  on  in  the  body, 
the  fuel  Lr  which  is  supplied  by  the  food  taken.  Food  being 
deficient,  the  body-temperature  would  necessarily  fall,  if  there 
were  no  reserve  of  combustible  material  stored  up  in  the 
tissues. 

It  is  evident  that  heat  may  be  economised,  and  thus  within 
certain  limits  the  amount  of  food  required  may  be  diminished 
by  preventing  some  of  the  loss  of  heat  from  the  body.  About 
*$o  to  90  per  cent,  of  this  loss  being  by  the  skin,  clothing  plays 
an  important  part  in  preventing  loss  of  heat. 

Clothing  should  prevent  as  far  as  possible  radiation  and  con 
duction  of  heat,  but  not  evaporation  of  the  perspiration.  The 
xnaterial  which  is  in  these  respects  best,  both  for  summer  and 
winter  wear  is  wool,  which  should  always  be  worn  next  the 
*kin ;  the  thickness,  and  not  the  material,  being  altered  accord- 
ing to  the  external  temperature. 

99  H  a 


100  SCHOOL   HYGIENE. 

The  amount  of  clothing  for  children  should  be  sufficient  to 
prevent  any  sensation  of  cold.  Excessive  clothing  may  make 
children  tender  by  increasing  the  tendency  to  catch  cold, 
owing  to  its  exciting  perspiration,  and  to  the  fact  that  the  extra 
clothing  is  often  thrown  off  at  irregular  intervals.  The  effect 
of  wearing  a  thick  scarf  round  the  neck  is  a  well-known 
instance  of  this. 

A  deficient  amount  of  clothing  is  even  more  dangerous. 
The  attempt  is  commonly  made  to  "  harden  "  children  to  bear 
exposure  to  cold  with  bare  arms  and  legs.  The  consequences 
of  this  hardening  theory  are  most  calamitous ;  not  a  few 
children  are  hardened  out  of  the  world,  and  those  who  survive 
suffer  permanently,  either  in  growth  or  constitution.  The 
dwarfishness  of  Laplanders  and  Esquimaux  is  an  illustration  of 
this  principle.  Children  produce  heat  less  freely,  and  lose  it 
more  quickly,  than  adults,  hence  the  great  mortality  of  children 
in  cold  climates  during  the  winter  months. 

Liebig  first  clearly  explained  the  importance  of  clothing,  say- 
ing :  "  Our  clothing  is,  in  reference  to  the  temperature  of  the 
body,  merely  an  equivalent  for  a  certain  amount  of  food."  It 
will  be  easily  understood,  therefore,  how  deficient  clothing,  like 
deficient  food,  may  produce  stunted  growth,  or  lay  the  founda- 
tion for  disease,  or  bring  latent  disease  into  activity. 

Children's  clothing  should  be  of  such  a  character  that  the 
warmth  is  uniformly  distributed.  No  extra  amount  of  chest 
protection  will  prevent  bronchitis  or  pneumonia,  if  the  legs  and 
feet  are  cold.  The  adoption  of  leggings  and  sleeves  for  young 
children  should  always  be  insisted  on.  Thin  loots  are  espe- 
cially objectionable.  There  is  a  great  sympathy  between  the 
feet  and  the  respiratory  tract.  Chest  affections  are  frequently 
due  to  cold  and  damp  feet.  The  boots  should  be  thick  enough 
to  keep  the  feet  dry  and  warm.  It  is  advisable,  in  some  cases, 
especially,  for  girls  to  bring  a  dry  pair  of  stockings  to  school. 


101 

Damp  garments  should  be  laid  aside  at  once  on  reaching 
home,  and  the  teacher  should  never  allow  a  scholar  to  remain 
in  school  with  wet  clothes. 

The  practice  of  wearing  thicker  outside  garments  while  in 
the  warm  school-room  is  very  objectionable.  The  skin  becomes 
relaxed  and  perspiration  occurs,  and  it  only  requires  the  sub- 
sequent exposure  on  the  journey  home  to  ensure  a  severe 
catarrh. 

The  clothing  should  not  be  changed  according  to  the 
calendar,  but  according  to  the  state  of  the  weather. 

The  wearing  of  summer-clothing  late  into  autumn,  and  the 
assuming  of  light  outer-garments  and  under-clothing  as  soon  as 
a  fine  day  in  spring  appears,  are  very  dangerous  for  children. 

Moist  cold  is  a  good  conductor  of  heat,  and  the  damp  chilli- 
ness of  an  early  November  requires  as  warm  and  thick  clothing 
as  the  dry,  clear  cold  of  January. 

Tight  clothing  of  any  kind  should  be  avoided.  It  interferes 
with  free  movement  and  so  prevents  proper  exercise. 

Tight  corsets  are  particularly  objectionable,  and  belts  round 
the  waist.  Tight  sleeves  and  skirts  prevent  free  movements  of 
the  limbs.  Stockings  should  be  supported  by  suspenders  and 
not  by  garters.  Tight  boots  destroy  the  natural  elasticity  of 
the  movements,  besides  interfering  with  the  circulation  and 
thus  causing  cold  feet.  High-heeled  boots  produce  an  uncer- 
tain and  ungraceful  gait  in  girls ;  they  throw  the  weight  of  the 
body  on  the  front  part  of  the  feet,  disturbing  its  balance,  and 
tending  to  produce  spinal  curvature.  The  soles  of  shoes 
should  be  broader  than  the  feet,  the  heels  low  and  broad,  and 
the  soles  should  be  thick  enough  to  keep  out  all  damp. 


CHAPTER  XVI. 
BATHS  AND  BATHING. 
Necessity  for  Cleanliness. — School  Baths  and  Swimming. 

IN  previous  chapters,  the  use  of  food  and  clothing  in  pre- 
venting loss  of  heat  and  maintaining  a  uniform  temperature 
has  been  briefly  discussed.  In  this  chapter  we  wish  briefly  to 
impress  the  fact  that  the  skin,  by  the  proper  use  of  water,  may 
be  brought  into  such  a  robust  condition  that  the  sudden  alter- 
nations of  temperature  to  which  children  are  necessarily  ex 
posed,  become  comparatively  free  from  danger, 

No  school  education  is  complete  which  does  not  teach  chil- 
dren the  necessity  for  a  clean  skin.  A  dirty  condition  of  the 
person  strongly  favours  the  incidence  of  infectious  disease,  as 
well  as  helps  to  produce  that  unpleasant  odour  which  com- 
monly belongs  to  the  air  of  a  school-room  full  of  scholars. 

The  disuse  of  soap  and  cold  water  to  the  skin  renders  the 
cutaneous  blood-vessels  deficient  in  tone,  and  thus  favours  the 
production  of  chills.  Where  morning  cold  baths  are  not 
well  borne  by  children,  sponging  with  a  wet  towel,  followed 
by  friction  with  a  dry  rough  towel,  forms  a  good  substitute. 

It  is  impossible,  even  if  it  were  desirable,  always  to  keep 
children  in  warm  rooms.       They  play  about  in  cold  corridors, 
or  other  places  exposed  to  cold  currents  of  air,  and  if  their 
102 


BATHS    AND    BATHING.  103 

skin  is  lacking  in  tone,  a  sore  throat  or  bronchitis  may  be  the 
result. 

School  bathing  is  very  desirable,  though  arrangements  are 
seldom  made  for  it.  Schools  containing  several  hundred  boys 
can  hardly  be  regarded  as  complete  unless  they  possess  a 
swimming-bath  of  their  own,  or  one  in  some  way  open  to 
them.  Many  unfortunate  accidents  would  be  prevented,  and 
much  gain  to  the  health  and  happiness  of  children  would 
result,  if  they  were  taught  to  swim.  A  boy  accustomed  to 
plunge  into  cold  water  (i.e,  at  50°  to  60°,  not  32°),  is  much 
less  likely  to  suffer  from  alternations  of  temperature  than  other 
children,  and,  if  by  chance  he  should  get  wet  through,  is  less 
liable  to  be  chilled  or  laid  up  by  fever. 

Swimming  combines  the  advantages  of  bathing  and  exercise. 
A  plunge  into  running  water  is  more  liable  to  produce  cramp, 
or  dangerous  chilling  of  vital  organs,  than  into  the  water  of  a 
swimming  bath,  as,  in  the  former  case,  the  water  around  the 
swimmer  is  constantly  being  changed,  and  so  a  greater  abstrac- 
tion of  heat  from  the  body  occurs. 

School  bathing  should  always  be  under  strict  supervision. 
Children  should  not  be  allowed  to  loiter  in  undressing ;  they 
should  never  be  allowed  to  remain  in  the  water  until  chattering 
of  teeth,  or  blueness  of  lips  or  nails  is  produced  ;  and  me  Daih 
should  not  be  taken  within  two  hours  ot  a  meal. 


CHAPTER  XVII. 
EYESIGHT  IN  RELATION  TO  SCHOOL  LIFE. 

Structure  of  the  Eye.— Causation  of  Long  and  Short  Sight.— Use  of 
Eyes  for  near  Objects.— Inadequate  Light.— Badly-printed  Books. 
—Fine  Needlework.— Influence  of  General  Health  on  Eyesight. 

IN  order  to  understand  the  influence  of  school-life  on  eyesight 
the  following  facts  relating  to  the  structure  of  the  eye  are 
important. 

The  eye  is  enveloped  throughout  the  greater  part  of  its 
circumference  by  a  dense  white  coat  (the  sclerotic),  the  trans- 
parent and  more  convex  cornea  enveloping  the  smaller  moiety 
in  front.  (Fig.  20;.  Inside  the  sclerotic  is  a  black  vascular  layer 
(the  choroid),  which  serves  to  absorb  excessive  rays  of  light,  and 
within  this  is  spread  out  the  delicate  meshwork  of  the  retina, 
which  receives  impressions  of  light  and  conveys  them  to  the 
brain.  The  interior  of  the  eyeball  is  occupied  by  a  transparent 
gelatinous  material  in  its  posterior  part,  and  a  watery  material 
in  front,  between  which  lies  the  delicate  lens  of  the  eye, 
which  is  capable  of  being  altered  in  shape  by  the  action  of 
minute  ciliary  muscles.  (3,  Fig.  20). 
104 


EYESIGHT   IN    RELATION    TO   SCHOOL    LIFE. 


105 


In  the  normal  eye,  rays  of  light  coming  from  a  distance  (i.e., 
practically  parallel  rays)  are  refracted  by  the  passive  lens  and 
media  of  the  eye,  and  brought  to  a  focus  at  the  most  sensitive 
part  of  the  retina,  without  any  muscular  effort.  Thus,  vision  of 
distant  objects  represents  rest  for  the  eyes,  and  exertion  of  its 
muscles  comes  into  play  only  for  near  vision. 


10 


FiG.  20— Vertical  section  of  the  eyeball 

I,  Sclerotic ;  2,  choroid  ;    3,  ciliary  muscle  ;    4  cornea  ;    5,  iris ;    6,  aqueous 
humour  ;  7,  lens  ;  8,  vitreous  humour  ;  9,  retina  ;  10.  optic  nerve. 

The  divergent  rays  of  light  from  a  near  object  are  brought 
to  a  focus  on  the  retina  by  the  action  of  the  ciliary  muscle, 
which  renders  the  lens  more  convex,  and  thus  capable  of 
refracting  the  light  more  powerfully.  The  effect  of  an  increased 
convexity  of  lens  in  bringing  divergent  rays  of  light  sooner  to 
a  focus  is  shown  in  Fig.  21.  If  for  any  distance  under  2oft. 
the  eye  were  not  able  thus  to  accommodate  its  condition,  a 
blurred  and  incomplete  image  would  be  formed  on  the  retina. 


io6 


SCHOOL   HYGIENE. 


A  child  with  normal  eyes  ought  to  be  able  to  read  this  page, 
in  a  good  light  at  the  distance  of  40  inches,  and  at  all  inter- 
vening distances  down  to  4  inches.  Any  child  who  cannot 


FIG.  21. — Diagram  showing  effect  of  a  biconvex  lens  on  rays  of  light. 

i.  Focus  of  parallel  rays  ;  2,  focus  of  divergent  rays  ;  3,  focus  of  divergent 

rays  brought  nearer  by  more  convex  lens. 

read  it  as  far  as  15  inches  off  should  have  his  eyes  examined 
by  a  competent  eye-surgeon.  A  rough  test  may  be  also  made 
by  means  of  the  following  letters  : — The  Z  should  be  distin- 
guishable at  a  distance  of  50  feet,  D  at  a  distance  of  40  feet,  Y 
at  25  feet,  H  at  20  feet,  and  L  at  10  feet. 


Y  H 


50  feet-  40  feet.  25  feet.  20  feet.         10  feet. 

Three  chief  defects  of  vision  occur  in  children  ;  in  the  first, 

|he  rays  of  light  are  brought  to  a  focus  behind  the  retina 


EYESIGHT    IN    RELATION   TO   SCHOOL   LIFE.  107 

(hypermctropia)  ;  in  the  second,  the  rays  of  light  are  brought 
to  a  focus  in  front  of  the  retina  (myopia) ;  and  in  the  third, 
the  different  axes  of  the  eyes  do  not  bring  rays  of  light  to 
a  focus  at  the  same  point  (astigmatism). 

Hypermetropia  or  Lotig-sig/it,  in  which  the  eye  is  shorter  from 
behind  forwards  than  usual,  is  really  in  a  moderate  degree  a 
normal  condition  in  childhood,  but  if  present  in  a  high  degree 
represents  an  arrest  of  development  Parallel  rays  of  light 
(/>.,  those  from  a  distance)  are  brought  to  a  focus  behind  the 
retina.  (Fig.  22.)  Thus,  when  the  eye  is  at  rest  there  is  not 


FIG    22. — Sec  ion  of  h\  \  ermetropic  eye. 

R,  the  origin  cf  divergent  rays  of  light ;  K,  the  focus  beyond  the  eyeball  ; 
LL,  convex  classes  to  be  worn  by  hypermetrope  ;  F'  the  focus  of  rays  o/ 
light  on  retina,  showing  influence  of  L. 

distinct  vision  even  of  distant  objects  for  the  long-sighted. 
The  ciliary  muscles  must  always  act  and  accommodate  the  eye, 
and  in  moderate  degrees  they  succeed  in  concealing  the  con- 
dition. It  is  evident,  however,  that  this  constant  strain  on  the 
muscles,  during  the  waking  hours,  must  be  injurious ;  and  during 
the  use  of  the  eye  for  near  vision,  as  in  reading  or  needlework, 
the  strain  on  the  ciliary  muscles  becomes  still  greater.  Conse- 
quently, congestion  and  redness,  with  watering  of  the 
result. 

The  lids  tend  to  stick  together  in  the  morning,  owing  to 
increased  secretion.  If  close  work  is  insisted  on,  in  severe 
cases  <?  ziness  and  total  inability  to  distinguish  letters  are  pro- 


108  SCHOOL   HYGIENE. 

duced,  and,  in  some  cases,  nausea,  or  even  vomiting.  The 
child  is  worse  in  the  morning  than  the  evening,  as  his  ciliary 
muscles  have  to  adjust  themselves  to  the  strain  imposed  on 
them.  Mistakes  are  frequently  made,  and  the  child  is  often 
thought  to  be  idle.  In  this,  as  in  other  abnormal  conditions  of 
the  eye,  it  is  very  common  for  the  child  to  have  been  repeatedly 
punished  by  his  teachers  for  supposed  obstinacy  or  stupidity. 

Long-sight  is  often  confused  with  short-sight,  because,  in  the 
former,  as  in  the  latter,  the  child  gradually  holds  his  book 
nearer  and  nearer  to  his  eyes.  This  is  because  spasm  of  the 
ciliary  muscle  (causing  accommodation  beyond  the  necessities 
of  the  case)  is  produced  by  the  efforts  to  see  small  objects  at 
moderate  distances,  and  because  the  large  size  of  the  image  of 
the  print  obtained  by  holding  the  book  nearer  partially  com- 
pensates for  its  imperfect  definition. 

In  the  effort  at  accommodating  long-sighted  eyes  for  near 
and  small  objects,  those  external  muscles  of  the  eyeballs 
which  turn  them  in  towards  the  nose,  are  brought  into  exces- 
sive action.  A  convergent  squint  may  be  thus  produced,  at 
first  occasional,  afterwards  becoming  constant,  and  one  eye 
being  usually  worse  than  the  other.  The  squint  is  worse  when 
the  child  is  tired  or  ill,  but  any  squint  in  a  child  4  to  7  years 
old  should  receive  immediate  attention. 

Myopia  or  Short-sight  is  the  exact  opposite  of  the  last  con- 
dition, the  eye  from  before  backwards  being  too  long,  so  that 
rays  of  light  from  a  distance  are  brought  to  a  focus  in  front  of 
the  retina.  In  order  that  they  may  be  focussed  on  the  retina, 
the  affected  child  finds  it  necessary  to  hold  objects  near  his 
eye,  thus  making  the  rays  of  light  more  divergent. 

Myopia  is  distinguished  from  hypermetropia  by  the 
fact  that  distant  vision  is  improved  by  a  concave  lens, 
and  by  the  fact  that  the  smallest  type  can  be  read 
easily,  provided  it  be  held  closely  to  the  eyes 


EYESIGHT   IN    RELATION   TO   SCHOOL   LIFE.  IOQ 

The  fact  of  a  person  seeing  equally  as  well,  at  a  distance, 
through  a  convex  lens,  as  without,  certainly  indicates 
hypermetropia. 


FIG.  23. — Section  of  myopic  eye. 

R,  the  origin  of  divergent  rays  of  light ;  F,  the  focus  of  these  in  front  of  retina  ; 
LL,  concave  lens  to  be  worn  by  myope  ;  F',  focus  of  rays  of  light  on  retina, 
showing  influence  ot  L. 

Myopia  is  essentially  due  to  the  soft  and  yielding  character 
of  the  tunic  of  some  children's  eyes,  enabling  the  pressure  of 
the  muscles  during  accommodation  to  elongate  the  globe.  The 
condition  when  started  may  remain  stationary,  but  in  some  cases 
the  continuance  of  the  cause  increases  the  elongation  of  the  globe. 
This  may  be  followed  by  stretching  and  atrophy  of  the  choroid, 
or  even  detachment  of  the  retina,  and  other  evil  consequences, 
resulting  in  partial  or  complete  destruction  of  vision. 

The  tendency  to  short-sight  is  generally  strongly  hereditary, 
but  it  may  be  acquired,  and  it  is  chiefly  during  school-life  that 
this  occurs.  Jager,  in  1861,  first  called  attention  to  the 
remarkable  development  of  myopia  during  school-life.  Dr. 
Cohn,  of  Breslau,  in  1865,  took  up  the  subject.  Having 
examined  the  eyes  of  10,060  children,  he  found  1,072  myopic, 
239  hypermetropic,  23  astigmatic,  and  396  whose  vision  was 
impaired  from  the  effects  of  previous  disease.  As  his  testing 
was  by  lenses  only,  he  probably  underrated  the  myopia.  In 
elementary  village-schools  he  found  1*4  per  cent,  of  myopia, 
in  town  elementary-schools,  67  per  cent.;  in  intermediate 


110  SCHOOL    HYGIENE. 

schools,  io'3  per  cent.  ;  high  schools,  197  ;  and  in  gymnasia, 
26*2  per  cent.  Among  medical  students  he  found  the  propor- 
tion in  the  first  year  of  study  52  per  cent.,  in  the  last  year  64 
per  cent.  At  Tubingen,  Gartner  found  that  of  600  theological 
students,  79  percent,  were  myopic. 

Although  Germany  has  until  lately  had  the  greatest  preva- 
lence of  defects  of  vision,  it  has  -by  no  means  a  monopoly  oi 
them.  In  all  the  cases  investigated,  the  fact  comes  out  that  the 
youngest  classes  have  the  fewest  myopics,  and  the  oldest  most. 
Drs.  E.  G.  Loring  and  R.  H.  Derby,  of  New  York,  found  that 
in  the  lowest  classes  3*5  and  in  the  highest  2678  per  cent 
were  myopic. 

The  statistics  furnished  by  the  Philadelphia  Committee,  of 
which  Dr.  Risley  was  chairman,  are  peculiarly  valuable,  as  a 
complete  examination  of  the  eye  (barring  the  use  of  Atropine) 
was  made  in  each  case.  2,422  eyes  were  examined  by  the 
committee,  and  174  afterwards  by  Dr.  Jackson,  of  West 
Chester,  on  the  same  plan,  each  case  requiring  on  an  average, 
twenty-eight  minutes'  examination. 

The  accompanying  chart,  from  Mr.  B.  Carter's  pamphlet  on 
"Eyesight in  Schools,"  shows  the  result.  (Fig. 24).  The  horizontal 
lines  give  the  percentages,  the  vertical  lines  the  different  classes. 
The  myopia  was  found  to  increase  from  4*27  per  cent,  in  primary 
classes  (average  age,  8 J  years)  to  19*33  Per  cent,  in  normal 
classes, while  the  hypermetropia  diminished  from  88*1 1  per  cent, 
to  66*84  per  cent.,  the  proportion  of  normal  vision  (emmetropia) 
remaining  nearly  stationary.  It  is  evident,  from  the  statistics 
just  advanced,  that  school-life  has,  under  conditions  which 
commonly  prevail,  a  most  deleterious  influence  on  eyesight. 

Astigmatism  is  a  condition  of  the  eyes  in  which  the  curva- 
ture of  the  cornea  is  not  uniform,  and  consequently  rays 
of  light  passing  through  it  in  different  meridians  have  a 
different  focus.  The  lines  running  in  a  given  direction 


EYESIGHT    IN    RELATION   TO    SCHOOL   LIKE. 


Ill 


look  blurred — as  all  the  horizontal  or  all  the  upright,  &c. 
Children  suffering  from  this  condition  often  appear  stupid 
or  inattentive,  because  there  is  in  this  defect  what  has  been 
aptly  called  "  slow  sight ";  a  word  is  not  recognised  quickly  on 
100 


H.,  66-84. 


vision  op 

Eimnet.roi>i;i.  7'01% 
Myopia,  4-27% 

Average  Age          b'b       11-6      14 

Pri-    Becou-  Gram-  Nor- 
mary    dary,     mar.    mal. 
School. 

FIG.  24,— Chart  showing  prevalence  of  near-sight,  far-sight,  and  normal 
vision  at  different  ages. 

first  sight,  but  "  it  seems  to  come  to  them  afterwards."  The 
defect  is  commonly  ascribed  to  near-sightedness,  but  ordinary 
convex  lenses  will  not  remedy  it;  lenses,  the  curve  of  which  is 
specially  adapted  to  each  meridian  of  the  eye,  being  required. 


112  SCHOOL   HYGIENE. 

The  causes  at  work  during  school-life  which  tend  to  produce 
defects  of  vision  may  be  classed  under  the  five  following  heads: 

(i.)  The  prolonged  exertion  of  the  eyes  involved  in  seeing  near 
objects.  School- work  usually  lasts  from  four  to  six  hours,  and 
the  home-lessons  sometimes  nearly  as  long.  During  a  great 
part  of  this  time,  the  accommodating  apparatus  of  the  child's 
eyes  is  being  strained ;  the  tissues  of  the  eyes  being  soft  and 
compressible,  evil  results  are  apt  to  occur,  especially  when  there 
is  a  hereditary  tendency  to  defects  of  vision.  Three  hours' 
good  work  is  always  better  than  five  hours  of  indifferent  work. 

The  posture  of  the  scholar  is  very  important.  He  should 
not  be  allowed  to  lean  lorward  with  a  bent  head.  In  writing 
we  have  a  good  instance  of  the  principles  involved,  and  the 
practice  to  be  followed.  The  movements  required  are  of  a 
complicated  character,  and,  like  the  complicated  movements 
concerned  in  speech  and  walking,  should  be  automatically 
performed.  In  fact,  the  more  automatic  and  the  less  conscious 
the  movements  become,  the  greater  is  the  degree  ot 
precision  attained.  Hence,  as  in  piano-playing,  where  the 
pupil  is  required  to  look  at  the  music  and  not  at  the  keys,  the 
pupil  who  is  writing  should  he  required  to  sit  erect,  and 
directly  facing  the  desk,  and  should  fix  his  attention  on  the 
matter  to  be  written,  rathefr  than  on  the  movements  of  the 
fingers.  The  desk  should  be  at  a  proper  angle  to  the  eyes, 
and  the  eyes  should  not  be  allowed  to  come  nearer  than 
12  inches  from  the  box>k  or  slate.  The  copy-book  should  be 
aslant,  to  allow  for  the  bend  in  the  writing ;  otherwise  a  twisted 
position  is  necessary. 

(2)  An  inadequate  amount  of  light,  or  an  ill-directed  light, 
causes  an  undue  strain  on  the  eyes.  The  amount  of  window 
area  required,  and  the  direction  of  the  light  admitted,  have 
been  already  discussed  (page  18).  It  is  probable  that  the 
preparation  of  home-lessons  in  semi-darkness  is  responsible  for 
much  injury  to  the  eyes. 


,         EYESIGHT   IN   RELATION   TO   SCHOOL   LIFE.  113 

Cohn  in  his  investigations  found  that  the  narrower  the  street 
in  which  the  school  stood,  the  higher  the  opposite  houses,  and 
the  lower  the  storey  in  which  lessons  were  given,  the 
greater  the  number  of  cases  of  myopia  among  elementary 
scholars.  He  proposed  that  30  square  inches  of  glass  (not 
including  the  window  frames)  should  be  allowed  for  every 
square  foot  of  floor-area. 

(3.)  Badly  printed  text  and  other  books  produce  the  same 
result.  The  type  should  be  clear  and  large,  Roman  being 
much  better  than  Gothic  type.  The  construction  of  such  let- 
ters as  h  and  b,  v  and  n  should  be  especially  precise. 

The  following  words  represent  well-known  sizes  of  type  : — 
Double  Pica.  Great  Primer.  Pica. 

No  type     smaller  than     pica  should 

Small  Pica.    Bourgeois.      Minion.       Pearl.       Brilliant. 
be  Used  while  teaching          children  te«t 

Cohn  proposes  that  the  type  of  ordinary  journals  should  be 
4  mm.  or  |  inch  in  height,  though  M.  Javal  thinks  it  may  be 
allowed  to  be  2  mm.  The  thickness  of  down  and  up-strokes, 
the  spaces  between  letters  and  words  and  between  lines,  and 
the  length  of  lines  all  require  attention. 

Letter-press  derived  from  a  worn-out  fount  gives  an  imperfect 
impression  of  the  letters.  The  loops  of  a  and  e,  of  b  dp  g  are 
apt  to  form  a  black  spot ;  long  letters  become  broken,  and  fine 
up-strokes  are  imperceptible. 

Books  for  children  should  not  be  too  large  and  heavy,  the 
spaces  between  the  letters  and  between  words  and  lines  should 
be  relatively  wide,  and  the  lines  not  too  long.  The  reading  or 
writing-book  should  be  placed  at  a  distance  of  twelve  to  fifteen 
inches  from  the  eyes.  The  most  agreeable  tint  of  paper  is  a 
cream-colour  or  a  pale  blue.  It  is  inadvisable  to  gloss  the 
sheets,  as  this  produces  a  dazzling  reflection. 
1 


114  SCHOOL   HYGIENE. 

It  is  important  that  too  small  a  handwriting  should  not 
be  allowed,  and  that  neither  writing  nor  reading  should  be 
permitted  in  the  dim  light  of  evening. 

Pale  ink  and  greasy  slates  are  very  trying  to  the  eyes. 

The  letters  on  many  maps  in  schools  are  most  trying  to  the 
eyes,  the  lettering  not  only  being  fine,  but  the  maps  having 
often  been  printed  from  old  and  worn  plates.  Maps  should 
contain  as  few  data  as  possible,  teaching  by  wall-maps  and 
outline  maps  being  preferable.  In  writing  lessons,  the  character 
of  the  writing  material  used  is  of  some  importance,  especially 
on  dull  winter  days.  Thus  the  furthest  distance  at  which  a 
specimen  of  slate-pencil  writing  was  recognisable,  as  compared 
with  a  specimen  of  lead-pencil  writing  of  the  same  size,  was  as 
7  to  8,  while  the  ratio  of  lead-pencil  to  pen  and  ink  legibility  was 
7  to  8,  and 'of  slate  writing  to  pen  and  ink  3  to  4.  The  bearing 
of  this  on  the  hygiene  of  the  eye  is  evident ;  pen  and  ink  writing 
should  be  used  where  possible.  Also  pale  ink,  or  ink  which 
turns  black  only  after  a  time,  should  be  abolished  from  school. 

(4.)  Needlework  is  a  too  frequent  cause  of  defective  vision  in 
girls.  Sewing  is  more  trying  to  the  eyes  than  any  work  that 
boys  have  to  do.  In  ordinary  coarse  calico  there  are  about 
70  threads  to  an  inch,  and  what  is  considered  good  work  con- 
sists in  taking  up  4  threads,  2  in  front  and  2  behind  the  cotton  ; 
while  in  moderately  fine  linen,  as  a  shirt-front,  there  are  120 
threads  to  an  inch,  so  that  the  sempstress  has  to  work  to  A  inch, 
a  much  smaller  distance  than  the  finest  print. 

The  sewing  required  of  children  should  be  neat  and  accurate, 
but  not  too  fine,  and  sewing  should  not  be  prolonged,  nor  under- 
taken in  a  bad  light.  Where  possible,  the  light  should  come 
from  above  for  needlework,  as  for  drawing  lessons,  and  such 
lessons  should  be  avoided  by  gas-light.  Needlework  and 
drawing  and  writing  lessons  should  always,  preferably,  be  given 
during  the  brightest  hours  of  the  day.  Lace-work  taxes  the 


EYESIGHT   IN    RELATION   TO -SCHOOL  LIFE.  115 

eyes  severely,  and  may  lead  to  absolute  loss  of  vision.  Working 
at  night  on  black  dresses  is  most  injurious.  Scarlet  materials 
are  somewhat  trying  to  the  eyes,  and  are  not  allowed  under 
the  London  School  Board  ;  blue  is  to  be  preferred. 

(5.)  The  condition  of  the  general  health  produced  by 
insufficient  exercise  or  food,  and  the  influence  of  a  vitiated 
atmosphere,  powerfully  favour  the  production  of  defective 
vision.  So,  likewise,  does  the  occurrence  of  catarrhal  or  other 
affections  of  the  eye,  as  after  measles,  diphtheria,  and  scarlet 
fever. 


CHAPTER  XVIII. 

_^-  COMMUNICABLE  DISEASES  IN  SCHOOLS.  — 

Moral  Duty  of  Parents  and  Medical  Men. — Symptoms  of  Onset  of 
Infectious  Diseases.— Rules  for  Guidance  of  Teachers.— Duration 
of  Infection. — Isolation  of  Healthy  Members  of  Household. — 
Diseases  from  Insanitary  Schools. — Question  of  Closing  Schools 
for  Epidemics. — Management  of  Infectious  Diseases  in  Boarding 
Schools. — Other  Communicable  Diseases. — Ringworm. — Itch. 

THE  question  of  infection  is  not  of  such  vital  moment  in 
a  day-school  as  in  a  boarding-school,  but  still  it  is  of  the 
utmost  importance  that  both  teachers  and  parents  should  be 
cognisant  of  the  general  facts  bearing  on  this  question.  An 
error  on  the  part  of  the  parent,  in  sending  a  child  to  school 
too  early  during  convalescence,  or  on  the  part  of  the  teacher, 
in  failing  to  recognise  the  early  symptoms  of  a  fever,  may  lead 
to  rapid  spread  of  the  disease,  and  a  thorough  disorganisation 
of  school-life. 

On  the  part  of  the  parent  or  guardian  an  increased  sense  of 
moral  obligation  is  much  needed.  Too  often  the  mother  is 
only  anxious  that  the  child  should  return  to  school  as  speedily 
as  possible,  regardless  of  the  evil  consequences  to  his  school- 
fellows ;  or  again,  the  existence  of  a  case  of  infectious  disease 
in  the  house  is  concealed,  in  order  that  other  children  from 
the  same  house  may  not  be  forbidden  to  attend  school. 
116 


COMMUNICABLE   DISEASES   IN   SCHOOLS.  117 

On  the  other  hand,  the  teacher  must  never  relax  rules  for 
particular  cases.  A  fixed  time  must  elapse  before  return  is 
allowed  (see  below),  and  this  must  be  adhered  to  even  though, 
in  exceptional  cases,  an  earlier  return  would  be  unattended 
with  danger. 

Family  doctors  should,  in  like  manner,  have  regard  to  the 
important  and  wide-spread  interests  involved,  and  always 
name,  as  the  earliest  period  for  return  to  school,  a  date  when 
every  possibility  of  infection  is  past. 

We  have  briefly  to  consider  in  this  chapter — 

(a)  Infectious  diseases  communicable   from  one   child   to 
another. 

(b)  Diseases,  like  typhoid  fever,   which   are  due  to   local 
insanitary  conditions,  and 

(e)  Certain  contagious  diseases  of  the  skin  and  eye. 

Specific  infectious  diseases  may  arise  in  connection  with 
school-life,  from  the  attendance  of  children  at  school  who 
are  either  (i)  suffering  from  the  early  symptoms  of,  or  (2) 
are  convalescing  from  infectious  disease,  or  (3)  who 
although  healthy  come  from  homes  in  which  infectious 
disease  is  present. 

The  first  and  second  of  these  causes,  unfortunately,  not 
infrequently  exist,  especially  in  the  case  of  measles,  whooping 
cough,  mumps,  scarlet  fever,  and  diphtheria.  It  is  essential 
to  the  elimination  of  these  causes,  that  teachers  and  parents 
should  be  familiar  with  (i)  the  symptoms  indicating  the  onset, 
and  (2)  the  duration  of  infection  in  these  diseases. 

Onset  of  Infectious  Diseases. — In  each  infectious  disease 
an  interval  elapses  between  the  reception  of  the  specific 
poison,  and  the  development  of  the  earliest  symptoms,  known 
as  the  period  of  incubation,  or  hatching.  During  this  time 
the  patient  may  be  in  fair  health  and  is  not  infectious,  accord- 
ing to  the  majority  of  medical  authorities. 


n8 


SCHOOL    HYGIENE. 


With  the  onset  of  the  earliest  symptoms,  he  becomes  a 
centre  of  infection,  though  usually  not  so  dangerously  as  a 
few  days  later.  The  period  of  incubation  of  the  various 
fevers  is  shown  in  the  following  table  : — 


Disease. 

Begins  usually  on  the 

But  may  possibly  be 
at  any  period 
between 

Scarlet  Fever 

4th  day 

I   &  7  days 

Diphtheria 

2nd 

2    &    < 

1  2th    , 

I  &   14        „ 

Chicken  pox    .    .   . 

1  4th 

TO  &  18 

Typhus  Fever  
Typhoid  Fever. 
Measles  

I2th    „ 

2ISt      „ 

1  2th-  1  4th  ,, 

I   &  21       „ 

I  &  28       ,. 

jo  &  14    n 

Rotheln  

1  4th 

12  &  l8      „ 

Mumps  

iQth 

l6  &  24 

Whooping  Cough... 

i4th     „ 

7  &  14    M 

Following  the  period  of  incubation,  come  the  premonitory 
symptoms,  which  usually  are  somewhat  sudden  in  onset. 

In  Scarlet  Fever  the  child,  as  a  rule,  vomits  and  becomes 
extremely  feverish,  at  the  same  time  complaining  of  sore 
throat.  Any  child  at  school  who  is  sick,  and  has  a  hot  dry 
skin,  should  be  immediately  sent  home.  Within  24  hours  a 
punctiform  red  rash  appears  on  the  chest,  soon  becoming  a 
scarlet  blush,  and  spreading  to  other  parts.  Some  cases  are 
so  slight  that  they  may  come  to  school  throughout,  and  be  dis- 
covered only  by  the  occurrence  of  peeling  or  dropsy  due  to  chill 
affecting  the  kidneys,  which  may  occur  after  the  mildest  cases. 

In  Diphtheria,  after  a  day  or  two  of  languor  and  sore  throat, 
white  patches  appear  on  the  tonsils  and  contiguous  parts, 


COMMUNICABLE   DISEASES    IN    SCHOOLS.  119 

which  in  severe  cases  join  together  to  form  a  continuous 
membrane.  Smaller  white  patches,  due  to  the  condition  called 
ulcerated  throat  (follicular  tonsillitis),  are  often  confused  with 
the  much  more  severe  disease,  diphtheria.  Both,  however,  are 
extremely  contagious  by  inhalation  of  the  breath,  and,  undoubt- 
edly, are  frequently  spread  in  schools,  when  mild  cases  have 
been  overlooked.  The  presence  of  sore  throat  and  feverish- 
ness,  would  always  justify  the  teacher  in  sending  a  scholar 
home,  with  a  note  to  its  parent. 

Small-pox  comes  on  with  severe  pain  in  the  loins,  sickness, 
and  shivering.  At  the  end  of  48  hours,  a  hard,  pimply  rash 
appears,  and  then  the  patient  usually  feels  better  for  a  while. 
A  patient  with  ordinary  small-pox,  would  be  too  ill  to  attend 
school  ;  but  the  modified  small-pox,  which  occurs  in  those 
partially  protected  by  vaccination,  is  a  much  milder  complaint, 
and  in  one  case,  known  to  the  writer,  a  boy  attended  school 
with  it,  being  supposed  to  have  a  "  spring  rash."  In  such  a  case 
small-pox  would  be  likely  to  spread  among  those  who  had 
been  imperfectly  or  unsuccessfully  vaccinated. 

Chicken-pox  may  come  on  with  hardly  any  premonitory 
symptoms,  except  slight  feverishness.  The  rash  comes  out  in 
24  hours — at  first  pimples,  but  speedily  becoming  clear 
vesicles.  There  may  be  some  difficulty  in  diagnosing  from 
modified  small-pox,  though  the  rash  in  the  latter  seldom  or 
never  appears  on  the  scalp,  as  it  does  in  chicken-pox. 

Measles  comes  on  with  all  the  symptoms  of  a  severe  cok1  in 
the  head,  with  an  unusual  amount  of  fever.  At  the  end  of  72 
hours,  red  blotchy  spots  appear  on  the  face,  hands,  and  other 
parts,  and  rapidly  spread,  tending  to  assume  crescentic 
arrangements. 

Rtihtln  or  German  Measles  has  a  rash  somewhat  like  that 
of  measles.  There  is  no  nasal  catarrh,  however,  and  always  a 
sore  throat,  similar  to,  but  less  severe  than,  that  of  scarlet- 


120  SCHOOL    HYGIENE. 

fever.  It  is  always  a  slight  complaint,  and  is  sometimes 
mistaken  for  the  rose-rash  due  to  indigestion,  &c.,  a  mistake 
which  may  lead  to  serious  results  in  large  schools.  In  all 
doubtful  cases,  the  safest  plan  is  to  act  as  if  it  were  the 
infectious  complaint. 

Mumps  comes  on  with  feverishness  and  pain  near  the  ear, 
followed  by  enlargement  of  the  parotid  salivary  gland.  This 
causes  bulging  out  at  the  side  of  the  neck  and  in  front  of  the 
ear,  by  which  means  it  can  be  distinguished  from  glandular 
enlargement  due  to  other  causes. 

As  a  rule  both  sides  are  affected,  but  occasionally  only  one. 

Whooping  Cough  is  a  disease  in  which  the  characteristic 
cough  does  not  come  on  for  a  week  or  two,  but  the  cough 
appears  to  be  simply  due  to  bronchial  catarrh.  It  is  unfortun- 
ate that  during  this  unrecognisable  stage  (unless  by  the  history 
of  infection)  the  disease  can  be  communicated  to  others.  At 
the  end  of  7  to  14  days  the  patient  begins  to  cough  till  he  is 
out  of  breath,  and  then  draws  in  his  breath  with  a  peculiar 
crowing  noise  or  whoop.  Every  teacher  should  be  familiar 
with  this  whoop,  and  send  any  child  home  who  has  it,  or  who 
even  without  it  has  a  cough  severe  enough  to  make  him  sick. 

What  has  been  said  about  the  onset  of  common  infectious 
diseases  may  be  summarised  for  the  practical  use  of  the 
teacher  as  follows  : — 

(i.)  Whenever  a  child  appears  at  school  with  a  suspicious- 
looking  rash,  or  if  he  is  sick  or  becomes  feverish  and  ill,  send 
him  home  at  once  with  a  note  to  his  parents. 

(2.)  A  bad  sore-throat,  with  feverishness,  might  indicate 
scarlet  fever,  diphtheria,  German  measles,  or  a  simple  sore- 
throat.  In  any  case  send  the  patient  home,  and  -stsfe  the 
mother  to  keep  him  away  from  school  until  the  true  nature  of 
the  complaint  becomes  certain. 

(3.)  If  a  child  is  suffering  from  a  severe  cold,  with  sneezing 


COMMUNICABLE   DISEASES   IN   SCHOOLS.  121 

and  redness  of  the  eyes,  it  mny  mean  an  influenza  cold  or 
measles.  As  both  are  contagious,  the  child  should  be  sent 
home. 

(4.)  A  swelling  in  front  of,  and  below,  the  ear,  nearly  alvsays 
means  mumps ;  while  a  paroxysmal  cough,  making  the  child 
sick  or  bleed  at  the  nose,  or  become  blue  in  the  face,  generally 
means  whooping-cough.  In  all  doubtful  cases,  act  as  though  it 
were  certain  that  the  case  was  an  infectious  one. 

Duration  of  Infection. — It  is  important  to  know  at  what 
period,  after  the  onset  of  an  infectious  disease,  a  child  may 
return  to  school.  This  should  theoretically  coincide  with  the 
end  of  the  period  of  infection,  but  as  it  is  wise  in  all  cases  to 
allow  a  margin,  we  have  given  the  duration  of  infection,  and 
the  period  at  which  return  to  school  may  be  allowed,  in  separ- 
ate columns  in  the  following  table.  In  the  fourth  column  is 
given  the  period  which  must  elapse  before  a  child,  who  has 
been  exposed  to  infection,  may,  in  the  absence  of  symptoms, 
be  allowed  to  return  to  school,  assuming  that  in  the  interval 
he  has  been  completely  isc  la  ed  from  any  source  of  infection. 
This,  again,  should  theoretically  coincide  with  the  longest  cor- 
responding period  of  incubation  given  in  the  last  table  (page 
1 1 8;,  but  it  is  well  to  allow  a  margin  for  the  symptoms,  if  com- 
ing on,  to  become  fully  developed. 

It  must  be  clearly  borne  in  mind  that  the  date  of  cessation 
of  the /#//>/// 'j  infection  is  stated  in  the  following  table.  It  is 
assumed  that  all  wearing-apparel  has  been  disinfected,  and 
likewise  the  room  occupied  by  the  child.  Sometimes  a  child 
is  taken  ill  in  a  particular  dress,  and  resumes  this  on  returning 
to  school,  thus  carrying  the  infection  with  him. 

A  scholar  who  has  been  suffering  from  infectious  disease 
should  rfever  be  re-admitted  to  school  without  a  medical  certi- 
ficate of  freedom  from  infection.  If  this  certificate  assumes 
freedom  from  infection  at  an  earlier  period  than  the  one 


122 


SCHOOL   HYGIENE. 


Disease. 

Duration  of 
Infection. 

Date  at  which 
School  attendance 
may  be  resumed. 

Duration  of 
Quarantine 
of  children 
exposed  to 
Infection. 

Scarlet  Fever 

From  5  to  8  weeks  ; 

Not    less    than    6 

14  days. 

ceases    when    all 

weeks  from    the 

peeling      of    the 
skin     has      been 

beginning  of  the 
rash     and     then 

completed. 

only  if  no  peeling 

or  sore-throat  is 

present. 

Diphtheria   ... 

From     14     to    21 

Not  less     than    3 

12  days. 

days. 

weeks,&  not  then 

if  strength  not  re- 

covered, or  if  any 

sore  throat  or  any 

discharge       from 

nose,  eyes,  ears, 

&c. 

Small  pox  and 

About       4     to      5 

When    every  scab 

18  days. 

Chicken  pox 

weeks. 

has  fallen  off. 

Measles 

From      2     to       4 

When      all      des- 

16  days. 

weeks,    when   all 

quamationis  com- 

cough and  bran  ny 

pleted,    not    less 

shedding  of  skin 

than  3  weeks  from 

has  ceased. 

beginning  of  rash 

Rotheln 

10  to  14  days. 

From  2  to  3  weeks 

16  days. 

varying  with  the 

attack. 

Mumps 

14     to     21     days, 
from  the  beginning 

Four    weeks   from 
the    beginning,  if 
all    swelling    has 

24  days. 

disappeareed. 

Whooping    .. 

6  weeks  from  the 

In  about  8  weeks. 

21  days. 

Cough 

b  eginning  of 

whooping,orwhen 

the     cough    has 

quite  ceased. 

Typhus  &  Ty- 
phoid Fevers 

4  to  5  weeks.    ... 

When         strength 
sufficient. 

28  days. 

COMMUNICABLE   DISEASES   IN   SCHOOLS.  123 

named  in  the  preceding  table,  the  question  should  be  referred 
to  another  doctor,  preferably  one  to  be  attached  as  an  official 
adviser  to  the  school.  It  sometimes  happens,  tor  instance, 
that  children  are  sent  back  to  school  with  a  medical  certificate 
of  freedom  from  infection  at  the  end  of  fourteen  days  from 
the  beginning  of  mumps,  which  is  at  least  a  week  too  early. 

The  admission  to  school  of  apparently  healthy  children  from 
infected  households  should  always  be  forbidden,  because  of  the 
possibility  of  their  carrying  the  infection  in  their  clothes,  or  of 
their  coming  to  school  while  having  the  disease  in  a  latent 
form  or  an  unrecognised  stage.  As  soon  as  the  teacher  knows 
of  the  existence  of  a  case  of  infectious  disease,  he  should  at  once 
exclude  from  school  every  child  living  in  the  same  house.  The 
Sanitary  Authorities  as  a  rule  communicate  with  the  teacher, 
instructing  him  not  to  admit  to  school  any  children  from  an  in- 
fected house.  Except  in  towns  where  the  compulsory  notifica- 
tion of  infectious  diseases  is  enforced,  the  proportion  of  cases 
known  to  Sanitary  Officials  is,  however,  very  small,  and  the 
teacher  is  consequently  warned  from  this  source  only  in  a  minor- 
ity of  cases.  The  London  School  Board  has  issued  instructions 
to  its  teachers,  that  they  shall  inform  the  Local  Sanitary  Author- 
ity of  all  cases  coming  to  their  knowledge.  This  regulation 
seems  to  be  seldom  obeyed.  The  enforcement  of  the  com- 
pulsory notification  of  infectious  diseases  by  parents,  would 
enable  teachers  and  health-officers  to  work  more  efficiently  to- 
gether, to  their  mutual  advantage. 

All  the  children  in  an  infected  house  should  be  kept  away  from 
school  while  the  infectious  disease  continues,  and  for  a  given 
period  of  quarantine  afterwards  which  is  stated  in  the  last  table. 
The  quarantine-period  must  be  assumed  to  start  from  the  end  of 
the  longest  possible  period  of  infection  of  the  last  person  who 
has  been  ill  in  the  house.  Thus,  referring  to  the  table,  it  will 
be  seen  that,  after  scarlet  fever,  an  exposed  child  must  not  re- 


I24 


SCHOOL    HYGIENE. 


turn  to  school  for  8  plus  2  weeks  ;  after  diphtheria,  21  plus  12 
days  ;  after  mumps,  21  plus  24  days,  &c. 

This  may  seem  an  unnecessarily  long  period,  but  the  only 
way  to  avoid  possible  infection,  is  to  adhere  rigidly  to  it  where 
children  have  remained  in  the  same  house  as  their  sick  brothers. 
Of  course,  if  the  healthy  children  have  been  removed  to 
another  house,  and  no  possible  communication  is  allowed, 
then  only  the  period  of  quarantine  given  in  the  last  column 
of  the  table  on  page  122  need  be  insisted  on. 

In  some  cases,  disease  has  been  acquired  from  some  local 
unsanitary  condition  of  the  school-premises.  Bad  drains  or 
closets  may  give  rise  to  typhoid  fever  or  diphtheria,  as  may 
likewise  a  tainted  water-supply.  In  the  former  case,  the  school 
should  be  closed  during  the  necessary  repairs ;  in  the  latter, 
the  water-supply  should  be  cut  off.  Bad  ventilation  may  serve 
to  intensify  an  imported  infection,  and  increase  its  virulence ; 
and  so  may,  likewise,  a  dirty  condition  of  the  walls  and  floors  of 
the  school. 

When  any  child  attending  school  has  been  discovered  to  be 
suffering  from  an  infections  disease,  he  should  be  sent  home, 
the  other  children  sent  into  the  playground,  and  then  the 
windows  widely  opened  and  the  floor  freely  sprinkled  with 
some  disinfecting  solution,  as  carbolic  acid,  i  to  60  of  water. 

The  necessity  of  closing  schools  for  infectious  disease  but  rarely 
arises.  Where  prompt  information  is  received  by  the  local 
sanitary  authority  of  the  occurrence  of  infectious  cases,  it 
is  rarely,  if  ever,  necessary  to  close  a  school,  as  the  children  of 
infected  households  can  be  kept  away. 

In  certain  exceptional  cases  it  may  be  advisable  to  close  a 
school.  Thus:  (i)  If  the  attendance  at  the  school  is  greatly 
reduced  by  a  severe  epidemic  (of  measles,  for  instance), 
preventing  the  continuance  of  a  regular  course  of  study. 
(2)  In  sparsely-populated  rural  districts,  where  children  rarely 


COMMUNICABLE    DISEASES   IN   SCHOOLS.  125 

meet  except  at  school,  closing  the  school  may  effectually  check 
the  spread  of  an  epidemic,  though  it  is  of  little  use  in  towns  or 
large  villages,  where  children  play  together  out  of  school- 
hours.  (3)  School  should  be  closed  for  a  few  days  or  weeks 
to  remedy  local  sanitary  defects.  If  a  drain  is  opened  during 
school-hours,  children  crowd  about  to  see  what  is  done,  and 
may  thus  receive  the  germs  of  diphtheria  or  typhoid  fever. 

To  prevent  the  origin  and  spread  of  infectious  diseases 
in  large  public  and  boarding  schools,  some  further  precau- 
tions are  required.  The  sanitary  conditions  of  the  school 
should  be  perfect,  the  water  and  milk  supplies  above  sus- 
picion, and  the  school  should,  if  possible,  have  its  own 
laundry. 

The  school  infirmary  or  sanatorium  should  preferably  be 
entirely  separate  from  the  rest  of  the  school,  and  should  have 
rooms  for  distinct  cases  of  fever,  and  other  rooms  in  which 
doubtful  cases  may  be  watched  until  their  true  character 


Fia  25.— The  itch  insect.    (After  Startin.) 


126 


SCHOOL   HYGIENE. 


becomes  evident.  The  importance  of  not  leaving  any  case  of 
illness  accompanied  by  a  rise  of  temperature  in  the  common 
dormitories  cannot  be  exaggerated.  It  is  generally  by  means 
of  doubtful  or  ill-marked  cases  of  fever  that  infection  is 
spread;  and  in  some  cases  it  is  necessary  to  wait  and  see 
whether  peeling  occurs  before  a  correct  diagnosis  can  be 
made. 


FlG.  26. — A  burrow  formed  by  the  itch-insect  in  the  epidermis,  showing  the 
mature  animal  and  nine  eggs  in  course  of  development.  Highly  magnified. 
(After  Startin.) 


COMMUNICABLE   DISEASES   IN   SCHOOLS.  127 

The  sanatorium  should  have  nurses'  rooms,  a  small 
kitchen,  bath,  and  water-closets  complete  in  itself,  and  isolated 
from  the  rest  of  the  school.  When  a  separate  building  is 
impossible,  the  top  floor  of  the  house  should  be  occupied,  and 
in  this  case  even  more  stringent  regulations  are  required.  One 
medical  attendant  should  attend  all  the  cases  of  sickness  in  a 
school.  Where  the  medical  responsibility  is  divided,  infection 
is  much  more  apt  to  spread. 

Certificates  should  be  demanded  from  the  guardians  or 
parents  of  children  on  their  return  after  vacations,  stating  that 
there  has  been  no  known  exposure  to  infection  for  at  least 
three  weeks.  Where  no  such  statement  can  be  obtained,  the 
pupil  should  be  placed  in  quarantine ;  he  should  have  a  warm 
bath,  strong  carbolic  soap  being  used,  and  his  clothes  and 
books  should  be  baked.  In  large  schools  it  may  be  advisable 
to  have  a  disinfecting  oven,  Washington  Lyon's,  in  which  super- 
heated steam  is  employed,  being  the  best  for  this  purpose. 

Other  Communicable  Diseases. — Scabies  or  Itch  shows  itself 
in  the  form  of  an  irritable  rash,  most  frequently  seen  between 
the  roots  of  the  fingers  and  in  the  bends  of  joints,  especially 
at  the  wrist.  It  is  due  to  the  rapid  multiplication  of  a  minute 
insect  not  unlike  a  cheese-mite  (Fig.  25),  the  female  of  which 
forms  oblique  burrows  in  the  epidermis,  laying  eggs  which  hatch 
in  about  14  days  (Fig.  26).  The  rash  simulates  eczema,  and  is 
liable  to  spread  all  over  the  body  if  its  true  nature  is  not  detected. 
It  is  very  contagious,  and  no  child  who  has  had  it  should  be 
allowed  to  return  to  school  without  a  medical  certificate,  and 
until  his  clothes  have  been  baked  or  washed  in  boiling  water. 

Rtngivorm  is  due  to  the  growth  on  the  skin  of  a  microscopic 
fungus  (Fig.  27).  Minute  spores  become  detached  from  the 
growth,  and  thus  infection  is  carried  elsewhere  to  the  same  per- 
son or  to  others  by  means  of  change  of  hats  or  bonnets,  or  by 
towels  or  brushes,  or  actual  contact  Hairdressers  occasionally 


128 


SCHOOL   HYGIENE. 


communicate  ringworm,  and  so  do  hatters  by  trying  on  numerous 
caps.  It  is  as  morally  wrong  to  send  a  child  with  ringworm  to 
a  hairdresser  or  hatter  as  if  he  were  suffering  from  scarlet  fever. 
The  frequency  of  ringworm  is  shown  by  the  experience  of 
Christ's  Hospital,  London,  in  which  children  from  all  parts 
cf  the  country,  and  all  grades  of  middle-class  society  are 
A  B 


XJ50  XI200 

FIG.  27. — Ringworm. 

A,  a  hair,  showing  filtration  with  the  growth,  magnified  150  times. 

B,  a  portion  of  the  fungus  magnified  1,200  times.     (Bristowe's  Medicine.) 

admitted.  In  the  ten  years,  1875-84,  1812  children,  aged  from 
8  to  10  years,  all  supposed  to  be  free  from  ringworm,  were  ex- 
amined for  the  first  time,  and  145  cases  were  detected,  or  about 
8  per  cent,  of  all  children  admitted. 

On  the  bare  skin,  ring-like  patches  with  raised  margins  are 
formed,  the  ring  gradually  widening  out  if  not  interfered  with. 
On  the  scalp  similar  patches  are  formed,  but  the  fungus 
extends  down  to  the  roots  of  the  hairs,  and  obstinately  remains 


COMMUNICABLE   DISEASES   IN   SCHOOLS.  129 

there,  even  when  the  superficial  parts  have  been  apparently 
cured.  It  frequently  happens  that  such  children  are  allowed 
to  return  to  school,  the  disease  breaking  out  again,  and  causing 
infection  of  other  children.  It  is  quite  a  mistake  to  suppose 
that  ringworm  is  necessarily  cured  when  the  hair  begins  to 
grow  on  the  diseased  places.  A  case  can  be  regarded  as  cured 
only  when  a  medical  man,  after  having  carefully  examined 
the  whole  scalp  in  a  good  light  and  scrutinised  every  suspicious 
spot  with  a  lens,  has  found  no  broken-off  stumpy  hairs  (often 
not  protruding  more  than  ^  to  £  inch). 

It  is  unfortunately  a  fact  that  many  children  recovering  from 
ringworm  are  certified  by  indiscreet  medical  men  to  be  free 
from  infection,  when  a  more  careful  examination  discovers 
numerous  hairs  in  which  the  fungus  is  still  alive.  One 
commonly  hears  the  remark  that  "  the  ringworm  is  better,  but 
has  left  a  scurfy  condition  of  the  head  behind."  The  teacher 
may  take  it  as  a  practical  rule  in  such  cases  which  will  very 
seldom  be  found  to  err,  that  the  scurfy  condition  indicates  a 
phase  of  ringworm  which  is  still  infectious.  The  power  of 
infection  may  continue  even  when  one  or  two  years  of  this 
scurfy  condition  have  elapsed. 

Catarrhal  Ophthalmia  is  marked  by  redness  of  the  eyes  and 
free  muco-purulent  discharge.  It  lasts  about  14  days,  and  is 
chiefly  important  because  it  is  contagious. 

Chronic  Granular  Ophthalmia  is  also  contagious,  and  all 
cases  should  be  isolated,  and  the  use  of  the  same  towels,  or 
water,  forbidden.  Badly-ventilated  dormitories,  insufficient 
food,  and  general  unhygienic  conditions  with  the  promiscuous  use 
of  towels,  are  chiefly  instrumental  in  producing  it.  Those  of  an 
Irish  nationality  seem  to  be  particularly  prone  to  suffer  from  it. 

Scald  head  (Contagious  Impetigo)  is  common  in  underfed 
children.  It  may  spread  to  other  children,  under  similar 
conditions ;  and  such  children  should  therefore  be  excluded 
from  school. 


130  SCHOOL   HYGIENE. 

In  concluding  this  long  but  important  chapter,  brief  allusion 
should  be  made  to  Chorea,  and  Hysteria,  which  are  com- 
municable by  imitation  and  sympathy,  and  for  this  reason 
should  be  excluded  from  school.  Every  teacher  should  be 
able  to  recognise  the  jerky  twitchings,  the  shuffling  of  feet,  the 
contortions  of  face  and  twitching  of  eyelids,  which  characterise 
Chorea  (St.  Vitus's  Dance;  and  children  suffering  from  this, 
require  prolonged  rest  from  school-work. 

Hysteria  is  chiefly  of  importance  in  girls'  schools.  It  as- 
sumes various  forms,  and  may  occasionally  simulate  either  a 
simple  faint  or  an  epileptic  fit.  It  is  distinguished  from  the 
former  by  the  absence  of  the  extreme  pallor  of  face  and  lips, 
which  characterises  fainting ;  and  from  the  latter  by  the  f  ict 
that  the  hysterical  patient  is  usually  not  completely  uncon- 
scious, as  shown  by  the  attempts  to  attract  sympathy  and  atten- 
tion, and  by  the  flinching  which  occurs  when  the  white  of  the 
eye  is  touched  with  the  point  of  a  finger.  The  patient  should 
be  treated  firmly,  though  kindly,  and  not  allowed  to  attract  too 
much  attention. 


CHAPTER  XIX. 
SCHOOL    ACCIDENTS. 

Importance  of  "  First  Aid.  "—Fainting.— Fits.— Suffocation.— 
Drowning.— Foreign  Bodies.— Stings  and  Bites. —  Wounds. — 
Hatnorrhage.— Burns. — Fractures,  Dislocations,  Sprains,  and 
Contusions.  —Football. 

THE  extreme  utility  of  "  First  Aid  "  to  the  injured,  is  shown 
by  the  popularity  which  the  St.  John  Ambulance  lectures  have 
attained.  To  teachers,  the  knowledge  of  "  First  Aid  "  is  par- 
ticularly useful,  for,  in  addition  to  the  numerous  accidents 
that  occur  in  connection  with  school  games,  instances  of 
children  having  fits  or  faints,  or  haemorrhage,  are  by  no  means 
uncommon.  Panic,  which  is  the  result  of  ignorance,  and,  still 
more  important,  injury  to  health  and  limb,  might  frequently 
be  prevented  by  the  application  of  the  simple  rules  of  treat- 
ment which  will  be  laid  down  in  this  chapter. 

It  must  not  be  supposed  that  we  are  encouraging  teachers 
to  take  upon  themselves  the  sole  treatment  of  serious  cases, 
although  we  may  have  to  describe  the  treatment  of  such  cases 
in  detail.  But  valuable  time  is  frequently  lost  before  a  medi- 
cal man  arrives,  and  it  is  therefore  highly  important  that  the 
teacher  should  know  what  to  do  in  the  interval.  Hence  a  not 
unsuitable  heading  for  this  chapter  would  be — "  Until  the  doc- 
tor comes." 

Fainting  in  schools  which  are  ill-ventilated  and  over-heated, 

11  K   2 


1 32  SCHOOL   HYGIENE. 

is  not  infrequent.  The  patient  should  be  laid  on  his  back, 
with  his  head  low ;  all  tight  clothing  should  be  removed  from 
his  neck ;  crowding  round  him  should  be  avoided,  and,  if  pos- 
sible, he  should  be  placed  in  a  free  current  of  air,  near  an 
open  door.  Do  not  attempt  to  pour  anything  down  the  throat 
while  the  patient  remains  unconscious,  otherwise  choking  may 
result. 

Fits  may  occur  in  school.  In  boys'  schools,  epileptic  fit 5 
occur ;  in  girls'  schools,  hysterical  fits  may  likewise  occur. 

In  epilepsy,  during  the  convulsions,  the  patient  should  be 
laid  gently  on  the  floor,  and  prevented  from  biting  his  tongue, 
if  possible.  All  tight  clothing  should  be  removed,  and  no 
further  attempt  at  active  treatment  made. 

In  hysteria,  as  a  rule,  the  patient  is  not  quite  unconscious  ; 
she  sobs  considerably,  and  is  evidently  in  a  highly  emotional 
condition.  She  will  not  allow  the  ball  of  her  eye  to  be  touched 
with  the  finger  without  flinching,  unlike  an  epileptic  patient. 
Hysterical  patients  should  be  removed  from  the  school  as  soon 
as  possible,  as  a  bad  example  of  this  kind  is  likely  to  spread. 
Their  morbid  condition  should  not  be  fed  by  over-attention  or 
indulgence. 

Suffocatioti  is  occasionally  imminent  from  a  marble  or  cherry 
stone,  or  similar  substance,  being  held  in  the  mouth,  and  then 
suddenly  sucked  down  into  the  larynx.  Such  an  accident  is 
always  serious,  and  a  doctor  should  be  immediately  called, 
the  messenger  being  instructed  to  tell  him  the  nature  of  the 
accident  in  order  that  no  time  may  be  lost.  In  the  meantime, 
the  only  safe  measure  is  to  put  the  finger  to  the  back  of  the 
throat,  in  the  hope  that  the  foreign  body  may  be  reached. 
Even  if  it  is  not  reached,  vomiting  is  commonly  excited,  and 
this  may  dislodge  it.  The  child  should  not  be  inverted  until 
the  doctor  arrives,  as,  if  it  is  not  successful,  the  symptoms  may 
be  aggravated. 


SCHOOL  ACCIDENTS. 


'33 


Apparent  Drowning  is  a  not  infrequent  accident,  especially 
in  country  districts  during  half-holidays,  and  the  teacher  should 
instruct  his  scholars  as  to  the  plan  to  be  followed  in  such  an 
emergency. 


FiG.  28 — The  inspiratory  movement  in  artificial  i  aspiration, 

The  appnrently-drowned  boy  should  be  placed  on  the  bank, 
his  mouth  cleansed  from  mud,  &c.,  and  his  tongue  drawn  for- 
ward out  of  the  mouth.*  A  folded  coat  should  be  placed  under 
his  head  and  shoulders,  so  as  to  give  firm  support.  Next,  the 
boy's  arms  should  be  grasped  near  the  elbows  by  the  operator, 
who  stands  over  the  boy,  facing  towards  his  feet.  The  arms 
should  be  drawn  over  the  boy's  head,  and  then  pressed  down 
firmly  against  the  sides  of  his  chest.  (Figs.  28  and  29.)  This 
manipulation  should  be  repeated  regularly  about  fifteen  times  ;i 
minute,  taking  care  not  to  perform  the  movements  hurriedly. 
The  upward  movement  expands  the  chest,  while  the  pn  s>ure  of 
the  arms  on  the  chest  causes  expulsion  of  air  from  it.  In  this 
•  See  Note  I.,  page  140. 


134 


SCHOOL   HYGIENE. 


way  inspiration  and  expiration  are  imitated,  and  the  natural 
process  of  respiration  may  in  favourable  cases  be  restored. 
At  the  same  time,  other  persons  should  secure  warm  and  dry 


FiG.  29. — The  expiratory  movement  in  artificial  respiration. 

blankets  and  hot  bottles,  and  should  rub  the  legs  steadily,  so 
as  to  help  the  circulation  and  keep  up  the  temperature  of  the 
body.  The  artificial  respiration  is,  however,  the  most  impor- 
tant point,  and  should  not  be  intermitted  until  natural  attempts 
at  breathing  occur,  or  until  half-an-hour  has  elapsed  without 
sign  of  recovery. 

Foreign  Bodies  are  occasionally  pushed  by  mischievous 
children  into  the  ear  or  nostril.  In  the  latter  case  they  can 
usually  be  seen  and  seized  by  a  pair  of  tweezers,  or  hooked 
down  by  a  fine  wire  hoop.*  In  the  former  case  simple  syring- 
ing with  warm  water  will  frequently  wash  out  the  foreign  matter. 
If  it  is  a  pea,  however,  syringing  is  better  omitted,  as  the  pea 
may  swell  and  thus  become  more  firmly  impacted. 

Minute  particles  of  dust,  &c.,  frequently  set  up  great  irrita- 
*  See  Note  II.,  page  140. 


SCHOOL  ACCIDENTS.  13$ 

tion  in  the  eye.  Try  to  invert  the  upper  eyelid,  and  then 
the  speck  can  usually  be  seen,  and  removed  with  the  corner  of 
a  pocket-handkerchief.  If  it  cannot  be  seen,  drop  a  little 
castor-oil  into  the  eye,  keep  the  eye  closed  and  immobile  by 
means  of  a  wet  compress  over  it,  and,  if  relief  is  not  obtained 
in  a  few  hours,  seek  further  advice. 

If  a  needle  becomes  imbedded  under  the  skin,  the  affected 
part  should  be  kept  fixed,  and  a  surgeon  seen.  Thorns  and 
splinters  may  usually  be  removed  by  cutting  through  the  top 
skin  (epidermis)  with  a  sharp  and  clean  knife,  and  then  seizing 
the  fragment  with  a  pair  of  tweezers.  If  the  splinter  is  under 
the  finger-nail,  its  removal  is  much  more  difficult,  and  the 
teacher  will  seldom  have  skill  or  Courage  to  cut  down  the  nail 
as  is  sometimes  necessary. 

The  Sfnigs  of  bees  and  wasps  are  best  relieved  by  first 
bathing  with  hot  water  and  squeezing  out  the  poison,  and 
then  applying  a  strong  solution  of  common  cooking  soda  to  the 
affected  parts.  The  same  treatment  holds  good  for  nettle-stings. 

The  Bite  of  a  dog  is  not  in  itself  serious,  unless  the  dog 
is  mad.*  As,  however,  the  fact  cannot  at  once  be  ascer- 
tained, it  is  wise  to  adopt  the  necessary  precautions  in  every 
case.  The  wound  should  be  bathed  with  hot  water  and 
thoroughly  sponged.  It  is  also  desirable  to  increase  bleeding 
from  the  wound  by  enlarging  it  with  a  sharp  pocket-knife. 
Lunar  caustic  is  of  little  service,  but  as  most  schools  have  some 
strong  nitric  acid  on  the  premises,  this  should  be  carefully 
applied  to  the  wound  by  means  of  a  penholder  dipped  in  the 
acid,  any  excess  of  the  acid  having  been  first  removed  from 
the  penholder. 

Wounds  of  varying  degree  and  severity  are  very  apt  to 
occur  in  connection  with  school-life.  The  wounded  part 
should  be  laid  bare,  and  the  wound  thoroughly  washed  with 
cold  water,  in  order  to  remove  any  grit  or  other  foreign 

*  To  make  sure  of  this  point,  it  is  wiser  not  to  shoot  the  dog 
until  the  doubt  is  fully  solved. 


136  SCHOOL   HYGIENE. 

matter  that  may  have  entered  it.  Then  the  edges  should  be 
brought  as  near  together  as  possible,  and  a  pad  of  linen 
moistened  with  cold  water  should  be  applied  by  means  of  a 
bandage.  The  patient  should  be  placed  in  such  a  position 
that  the  edges  of  the  wound  will  not  be  strained ;  thus,  if  the 
wound  is  on  the  cheek,  speaking  and  chewing  should  be 
avoided  ;  if  on  the  leg,  walking  must  not  be  allowed.  Punc- 
tured wounds,  from  knives,  &c.,  may  be  more  serious  and  in 
all  doubtful  cases  a  medical  man  should  be  seen. 

Abrasions,  in  which  the  skin  is  rubbed  off,  are  best  treated 
by  washing  carefully  with  cold  water,  and  then  applying  some 
Friar's  balsam  or  collodion.  For  wounds  and  abrasions,  stick- 
ing-plaster should  never  be  applied  alone.  It  nearly  always 
sets  up  irritation  and  causes  the  wound  to  suppurate. 

Swollen  glands  are  apt  to  occur  after  a  wound  or  whitlow,  or 
other  injury.  Thus,  a  swelling  under  the  armpit  may  occur  from 
a  poisoned  finger.  Such  a  condition  requires  careful  attention, 
rather  to  the  cause  of  the  enlarged  glands,  than  to  the  glands 
themselves.  Enlarged  glands  in  the  neck  are  not  infrequently 
due  to  lice  in  the  head  or  a  discharge  from  the  ears,  or  sore 
eyes,  or  a  rash  on  the  head  or  face.  Given  that  these  conditions 
are  removed,  the  enlarged  glands  disappear,  unless  some  dis- 
order of  the  general  health  co-exists. 

Hemorrhage  is  due  to  the  rupture  of  a  blood-vessel.  This 
may  be  due  to  a  wound,  or  may  come  from  the  lungs,  nose, 
or  other  parts,  independently  of  external  injury. 

Arterial  bleeding  is  the  most  serious,  and  is  distinguished 
from  venous  or  capillary  bleeding,  by  its  greater  amount,  by  the 
bright  scarlet  colour  of  the  blood,  and  by  the  fact  that  it  comes 
out  in  intermittent  jets,  corresponding  to  the  beats  of  the  heart. 

Venous  or  capillary  bleeding  can  always  be  controlled  by 
placing  a  linen  pad  on  the  wound,  and  firmly  bandaging  it  in 
its  place. 


SCHOOL   ACCIDENTS.  137 

To  control  arterial  bleeding,  the  same  measure  is  usually 
successful,  only  the  pad  must  be  made  firm  and  hard,  and 
tightly  bound  in  its  place.  If  a  main  artery  is  divided,  as 
shown  by  the  great  spurting  of  blood,  a  firm  pad  may  be  held 
firmly  pressed  by  the  two  thumbs  over  the  wound  until 
further  aid  can  be  obtained.  If  the  teacher  knows  the  course 
of  the  main  blood  vessels  in  the  limb,  he  may  stop  the 
haemorrhage  by  pressing  his  thumb  over  the  main  artery 
higher  up  the  limb ;  but  as  a  rule,  he  will  probably  be  more 
successful  by  trusting  to  a  firm  pad  kept  forcibly  pressed  over 
the  wound  itself. 

An  elevated  position  of  the  limb  will  help  to  stop  bleeding 
from  it,  and  a  flexed  position  of  the  joint  next  above  the 
wounded  part  has  a  similar  effect.  Thus,  with  a  severe  wound 
in  the  palm  of  the  hand,  apply  a  pad  firmly  over  the  wound, 
bend  the  elbow,  and  keep  the  whole  arm  raised.  If  cough- 
ing or  vomiting  of  blood  occurs,  keep  the  patient  perfectly 
quiet,  and  give  nothing  except  ice  to  suck,  and  obtain  medical 
aid  at  once.  In  bleeding  from  the  nose,  apply  iced  com- 
presses to  the  nape  of  the  neck,  and  syringe  the  nose  out  with 
iced  water.  If  this  does  not  answer,  put  some  alum  or  tannin 
in  the  water  to  be  injected  into  the  nostril,  or  pack  the  nostril 
with  a  large  wad  of  cotton  soaked  in  alum-water.  If  the  bleed- 
ing still  continues,  a  powder  containing  30  grains  of  bromide  of 
potassium  may  be  given  in  water,  and  repeated  in  half  an  hour 
if  necessary.  This  seldom  fails  to  stop  the  haemorrhage. 

Bums  are  apt  to  occur  in  connection  with  open  fires  or  hot 
water  pipes.  The  best  immediate  application  is  probably  a 
linen  cloth  soaked  in  a  saturated  solution  of  common  cooking 
soda,  which  very  quickly  relieves  the  pain  and  burning. 

The  following  injuries  are  most  apt  to  occur  in  connection 
with  football,  though  occasionally  from  cricket  or  in  the 
gymnasium : 


IS  SCHOOL   HYGIENE. 

Fractures  are  recognised  by  inability  to  use  the  affected 
limb,  shortening  and  alteration .  in  its  shape,  and  a  grating 
sound  when  an  attempt  is  made  to  move  it.  There  is  no 
urgency  about  treating  a  broken  limb  before  the  arrival  of  a 
surgeon.  If  it  is  necessary,  however,  to  remove  him  indoors, 
the  limb  should  first  be  secured  in  splints,  and  he  should  -be 
carried  on  an  improvised  stretcher.  Splints  may  be  improvised 
by  taking  long  pieces  of  a  box-lid,  or  an  umbrella ;  or  for 
children,  brown  paper  folded  up  so  as  to  be  stiff  and  rigid. 

Dislocations  are  liable  to  be  confused  with  fractures,  but  the 
limb  is  more  fixed  than  in  fracture,  and  there  is  no  grating 
sound  or  movement.  The  fact  that  the  injury  is  obviously 
near  a  joint  helps  to  a  diagnosis,  though  sometimes  fractures  may 
occur  close  to  a  joint.  Any  attempt  at  replacing  the  dislocated 
bone  by  an  unskilled  person  is 'dangerous. 

Sprains  are  best  treated  by  bandaging  immediately,  and 
applying  spirit  and  water,  or  some  quite  warm,  soothing 
lotion.  The  part  should  be  kept  immobile,  and  the  after- 
treatment  requires  great  care. 

Contusions^  as  from  a  kick  on  the  shin  or  a  blow  in  the  eye, 
result  in  the  effusion  of  blood  under  the  skin  (as  in  the 
"black  eye").  The  effusion  may  be  minimised,  and  its 
absorption  helped  by  a  cold  evaporating  lotion. 

More  serious  accidents  occasionally  happen  in  cricket  and 
football.  In  cricket,  a  fatal  result  has  occasionally  followed  a 
blow  behind  the  ear  by  the  cricket-ball.  It  is  difficult  to 
suggest  precautions  that  would  prevent  the  possibility  of  this 
accident. 

In  football,  a  blow  or  kick  over  the  abdomen  or  chest  may 
cause  sudden  death,  or,  short  of  this,  complete  collapse,  which 
in  some  cases  requires  several  weeks  before  complete  recovery 
occurs. 

In    lawn-tennis,  the   right   elbow  is   sometimes   peculiarly 


SCHOOL  ACCIDENTS.  1 39 

injured.  This  is  now  well  recognised  under  the  name  of  the 
"tennis-arm."  It  is  due  to  injury  of  certain  ligaments,  or  a 
small  muscle  near  the  elbow-joint.  The  only  remedy  is 
abstinence  from  the  game  for  a  prolonged  period. 

Football  has  the  unenviable  reputation  of  being  the  pastime 
which  is,  far  above  all  others,  liable  to  be  accompanied  by 
serious  or  even  fatal  accidents.  Scarcely  a  week  passes  in  the 
football  season,  but  several  accidents  are  recorded  in  the  news- 
papers ;  and  the  following  are  but  a  few  of  many  culled  by  the 
Lancet  in  the  course  of  a  few  weeks  : — "A  had  his  right 
leg  broken  by  a  cross  kick."  ".#,  while  engaged  in  a  match, 
was  kicked  in  the  stomach  ;  but,  feeling  better  afterwards,  he 
finished  the  game.  He  died,  some  time  afterwards,  from  in- 
ternal injuries."  ltC  had  his  collar-bone  broken."  "£>'s  left 
leg  was  broken  clean  through."  "E  received  a  severe  kick  on 
his  left  leg,  by  which  two  bones  were  broken  just  above  the 
ankle."  "  F,  while  running  with  the  ball,  slipped  forward  and 
was  fallen  over  by  those  pursuing  him,  his  back  being  broken 
in  the  me!6e."  Two  cases  have  come  under  my  own  observa- 
tion within  the  last  month.  In  one,  a  knock  on  the  chest  by 
an  opponent's  knee  caused  complete  collapse  and  uncon- 
sciousness, and  the  patient  at  the  end  of  three  weeks  remains 
weak  and  shaken.  In  the  other,  the  nose  was  cut  across  in  a 
fall,  and  severe  haemorrhage  occurred. 

The  Committee  on  Athletics  at  Harvard  University, U.S.A., 
about  a  year  ago,  being  convinced  that  the  game  of  football,  as 
at  present  played  by  college  teams,  is  brutal  and  demoralising 
to  players  and  spectators,  and  extremely  dangerous,  proposed 
to  request  the  faculty  to  prohibit  the  game.  We  confess  that 
this  is,  in  our  opinion,  the  only  reasonable  conclusion.  Unless 
the  game  can  be  radically  altered — for  fatal  accidents  happen 
with  both  Rugby  and  Association  play — the  sooner  another 
game  takes  its  place  the  better.  "  Charging  "  should  be  for- 


140  SCHOOL   HYGIENE. 

bidden ;  handling  the  ball  and  running  with  it  should  be  for- 
bidden ;  a  hard  and  dangerous  condition  of  the  ground  from 
frost  should  always  be  a  sufficient  reason  for  postponing  the 
game  ;  and  the  game  should  be  confined  entirely  to  the 
young,  who  seem  to  escape  more  readily  than  those  of  mature 
years.  If,  by  some  means,  football  could  become  true  to  its 
name,  and  not  be  foot-and-hand-ball,  and  if  kicks  could  be 
made  to  fall  more  on  the  ball,  and  less  on  the  shins  and  bodies 
of  the  players,  its  retention  as  a  rational  game  might  be 
tolerable. 

The  following  notes  are  to  accompany  pages  133  and  134,  which 
see: 

NOTE  I.  —  To  free  the  lungs  of  water,  protect  the  face  while  the 
body  is  gently  turned  face  downwards ;  let  some  one  stand  astride 
the  body,  and  joining  his  hands  under  the  abdomen  lift  that  part 
up  high,  making  a  few  sharp  jerks,  the  head  hanging  low,  and  the 
tongue  drawn  out.  In  a  few  moments,  as  soon  as  the  water  ceases 
to  escape,  turn  the  body  over,  and  place  a  folded  coat  under  the 
head  and  shoulders,  so  as  to  give  firm  support. 

NOTE  II.  —  Instant  relief  is  often  afforded  by  closing  with  firm 
pressure  the  free  nostril,  placing  the  mouth  over  the  open  mouth  of 
the  patient,  and  blowing  forcibly. 


INDEX. 


PAGB 

Abrasions    .       .       .       .136 
Age  in  relation  to  school- 
work 71 

Ague 4 

Air,  amount  required  .        .      27 
Air  space  in  dormitories    .      93 
Alternation  of  subjects       .      66 
Arrangement    of     school- 
work 66 

Artificial  lighting        .        .      17 
Astigmatism       .        .        .no 
Automatic  flush-tanks        47,  53 
Atrophy    from    disuse    of 
organs      ....      85 

Back  to  seat       .       .  15 

Bathing       ....  102 

Bites 135 

Blackboard  16 

Bleeding      .               .       .  136 

Blood  supply  to  brain        .  59 
Books  and  eyesight    .        .113 

Boots 101 

Boyle's     mica-flap    venti- 
lator    34 

Brain,  structure  and  size    .  58 

Brain-forcing      ...  62 
Bridgeport       system       of 

warming  ....  44 

Burns 137 

Calisthenics        ...  89 

Central  system  of  heating  41 

Cesspools     ....  52 
Chicken-pox        .        .        .119 

Childhood,  growth  in         .  70 

Chorea  from  school-work  .  64 

Cleanliness  ....  102 

Cloak-rooms       .       .       .  10 


Closed  stoves     •       •       • 

Closets         . 

Closing  schools  for  in- 
fectious disease 

Clothing      . 

Consumption  from  damp 
soil  .  . 

Consumption  from  over- 
crowding . 

Consumption  from  over- 
work. . 

Contusions  . 

Corporal  punishment       . 

Corridors     . 

Corsets  .        . 

"Cram"   system 

Cubic  space  allowed  .       • 

Damp  clothing   . 
Damp-proof  course    .       • 
Desks  , 

Diet 

Differentiation  of  functions 

of  brain    . 
Diphtheria 
Direction  of  light 
Disconnecting  chamber 
Dislocations. 
Distance  and  difference  o 

desks 

Dormitories 
Drainage  arrangements 
Drain-pipe  . 
Drainage  of  soil . 
Dress,  in  relation  to  food 
Drowning    .       . 
Dryness  of  air     .       , 


PAGE 

40 
48 

124 
99 

4 
25 
68 


10 

101 

65 

27 

100 

7 

12 

94 


lie 

18 


4 
99 


Earth-closets      .       ,       .     52 


142 


Index. 


PAGE 

Early  education,  character 
of  .        .        .61,  71 

Effects    of  breathing  im- 
pure air    .        .        .        .24 

Emulation,    evils    of,    for 
girls 80 

Epilepsy      .       .       .       .132 

Examinations      ...      67 

Exercise       ....      83 
„        effects  on  brain,  .      85 

Extraction  shafts  for   foul 
air 44 

Eyeball,  structure  of, .        .    104 

Far-sightedness  .  .  .  107 
Fat,  importance  of,  as  food  96 
Fits  ....  130,  132 
Floor  and  floor  plan  .  .  9 
Floor  space  per  child.  .  27 
Food  and  work  ...  96 
Football  .  .  .  .139 
Foreign  bodies  .  .  .134 
Foundation  •  .  7 

Fractures  .  .  .  .138 
Furniture  of  school  .  •  .  12 

Gas  lights  .        ,       .      19 

Gas  stoves  ....  39 
German  measles.  .  .119 
Glandular  Dwellings  .  .  136 
Ground-water  ...  3 
Growth  and  development .  73 
Growth,  rate  of  .  .  74,  78 
Gymnastics.  ...  89 

Haemorrhage  .  .  .136 
"  Hardening  "  of  children .  99 
Headache,  causes  of .  .  63 
Height  of  children  .  75,78 
Home  lessons  ...  66 
Hot  air  furnaces  .  .  .  41 
Hot  water  apparatus  .  .  42 
Hypermetropia  .  .  .107 
Hysteria  .  .  •  .132 

Incubation  period  .  .117 
Infectious  diseases  .  -115 
Infection,  duration  of  .120 
Itch 127 


PAGE 
6l 


Kindergarten  system . 


Lawn-tennis  arm        .        .  138 

Lavatories  ....  46 

Liebreich  on  seat-backs     .  15 

Liebreich's  chair.         .        .  86 

Lighting  of  schools     •        .  17 
Long  sight  .        .        .        .107 

Measles       .        .        ,        .119 

Mental  exercise  .        .        •  57 

Merit  grant.        ...  72 

Mumps        ....  120 

Muscles. in  relation  to  brain  60 

Music  exercises  ...  79 

Muscular  exercise      .        .  82 

„  „       effect  on 

brain        ....  84 

Myopia        ....  108 

Natural  ventilation    .        .  30 
Needlework  in  relation  to 
eyesight  .        .        .        .114 

Open  fire-place  ...  37 

Ophthalmia.         .        .        .  129 

Over-exertion,  effects  of    .  85 

Over-growth,  dangers  of    .  74 

Over-pressure     ...  65 

Pan  closet  .        ...  48 
Phthisis,  see  Consumption. 

Physiology  of  respiration  .  21 

Pictures  16 
Playgrounds         .        .        .6,  10 

Posture,  influence  on  health  12 

Precocity      ....  62 

Puberty  and  school-work  .  80 

Punishments       ...  68 

Quarantine  period      .        .  122 

Recreation                   •       .  82 

Recreative  exercise            •  87 

Rest 91 

Ringworm  ....  127 
Rotheln        .        .        .        .119 

Rules  respecting  ventilation  30 


Index.                                         143 

PAGE 

PAGB 

Sanatorium  .       4       • 

12$ 

Temperature    of    air    re- 

Scabies       .        •       • 

127 

quired       ....      25 

Scald  head  .       .       . 

128 

Tests  for  air  impurities      .      23 

Scarlet  fever 

II* 

Tobin's  tubes                            33 

School-work  after  acute  ill 

Training,  effect  on  muscles, 

ness  .... 

64 

&c.     .                ...      83 

School-work,  duration  of 
Seats    .... 

72 

Tumbler  and  trough  closets      49 
Type  of  books     .        .        .     113 

Sensations   in  relation   to 

brain. 

60 

Sex  in  education. 

78,80 

Urinals        ....      47 

Sheringham's  valve  v 

enti 

lator  . 
Short  sight  . 

M 

Valveless  closet  ...      49 

Site  of  school 

3 

Ventilating  closed  stoves  .      40 

Sleep    . 
Slope  of  desk 

92 
14 

,,           gas  burners     16,34 
Ventilation  .       .        .       .21 

Smallpox 

119 

Walls,  internal  surface       .       8 

Soil,  characters  of 

5 

„      structure  of      .        .        7 

Soil-pipe 

5° 

/ 

Sprains 

138 

Staircases    . 

10 

Warming,  expense  of       .      37 

Steam  heating  nppar 
Stings  . 
St.  Vitus's  dance 

tus 

42 

135 
no 

Water  supply      ...      97 
Weighing  students  periodi- 

Subsoil  water 

*J 

3 

Weight  of  children            .75.78 

Suffocation  . 

132   t    Whooping  cough                     120 

Surroundings  of  school 

5   i   Window-urea       .                .      18 

Swimming  . 

103 

Wounds       .                        •    135 

Symptoms  of  onset  of  in- 

Writing lessons  .                •    H3 

fectious  disease       .       .    117 

Writing  materials               .    114 

[UHI7BRSIT7] 


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